HomeMy WebLinkAboutDrain Layers Permit 78 Highland Drive -r/ AW M
TOWN 'OF SOUTH WINDSOR
DEPARTMENT OF POLLUTION CONTROL
South Windsor, Connecticut
DRAIN LAYER 'S PERMIT N? 277
' 4 fur 197
Pursuant to written application, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at 78 NAMM& *o* WA 97# 1 on the
side, between V0040A My* W ftm hab DA"
at premises owned by 1021t#P Yip smA
whose address is
and to I Lay House Drain, Repair House Drain, Lay Main, Other
for 1Msidl11tal occupancy or use,
with "* (0 Family Units, with acres.
Type of Sewage to be connected under this permit:
(SANITARY SEWAGE,) INDUSTRIAL WASTES, OR
Connection will be made with-- min- ( ) ,'s aw
Permit to be issued to a"** 4A& Uf
the holder of Drain Layer's License No. V . Permit will expire on 12 ABOA 9
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 ja t am* Md " d
Signed `'
Connection Charge Paid X "-1*-?3 Licensed Drain Layer
' X (Sig) Issued by "A�t" sk
Tax Collector
Permit Fee: Paid $ ISM
INSPECTION: t
INITIAL (Sig)
FINAL (Sig)
APPROVED r Q Jj.A rq 4, 1 Q j 3 (Date)
Af
aj& . (Sig)
INSPECTOR
Y1 v
N
N
A
NOTES_ SOUTH WINDSOR POLLUTION CONTROL
LOCATION �j
OWNER W a
TYPE OF WORK
DATE 6 i 2 ,?3 PERMIT PIPE ' L
INSTALLER D,6 G cnws
INSPECTOR W DRAWN BY-;�