HomeMy WebLinkAboutDrain Layers Permit 62 High Screet OF SOUTH WIN DSOR
DEPARTMENT OF POLLUTION CONTROL
South Windsor, Connecticut
DRAIN LAYER' S PERMIT 293
A_
C._. 19 t`
Pursuant to written application, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at !T '. ;' 'y t on the
side, between
at premises owned by
whose address is ..
and to t� Lay House Drain Repair House Drain Lay Main, Other
for occupancy or use,
with Family Units, with acres.
Type of Sewage to be connected under this permit:
SANITARY SEWAGE, INDUSTRIAL WASTES, OR
Connection will be made with
r r
Permit to be issued to ail .�
the holder of Drain Layer's License No. K.J `' - n -�"q Permit will expire on 19
The undersigned Drain Layer hereby agrees to all the terms and conditions set forth on the permit and the reverse side
thereof. Applicant has received Town Permit No. and/or C H D Permit No.
for street excavation.
SPECIAL CONDITIONS
Signed
Connection Charge Paid $ ' Licensed Drain Layer
(Sig) issued by
Tax Collector
Permit Fee: Paid $
INSPECTION: ; ; ! _
INITIAL (Sig)
FINAL (Sig)
APPROVEDs2. ,h. ,,-6 I Q1'4 (Date)
T'6'AL (Sig)
INSPECTOR
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N
oa
A
NOTES_ SOUTH WINDSOR POLLUTION CONTROL
LOCATION .
OWNER ac! sr-As
TYPE OF WORK vnt
DATE ce -zz-'?3 PERMIT
INSTALLER
INSPECTOR MCS DRAWN BY