HomeMy WebLinkAboutDrain Layers Permit 94 Highland Drive TOWWOF SOUTH WINDSOR
DEPARTMENT OF POLLUTION CONTROL
South Windsor, Connecticut
DRAIN LAYER ' S PERMIT 253
19
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Pursuant to written application, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at OTyJ
on the
7' side, between
at premises owned by
whose address is
and to 6' Lay House Drain, Repair House Drain, Lay Main, Other
for .•� "f
occupancy or use,
with. f; Family Units, with acres.
Type of Sewage to be connected under this permit:
iSANITARY SEWAGE,} INDUSTRIAL WASTES, OR
Connection will be made with
Permit to be issued to
the holder of Drain Layer's License No. Permit will expire on r 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
f
Signed
Connection Charge Paid $ .: icens rain Layer
Tax C2511ector (Sig) issued by
Permit Fee: Paid $
INSPECTION:
INITIAL (Sig)
FINAL (Sig)
APPROVED ok NE 1,4 (Date)
(Sig)
I SPECTOR
N
tA
NOTES SOUTH WINDSOR POLLUTION CONTROL
LOCATION
OWNER
TYPE OF WORK
DATE ,ve 2. 7 3 PERMIT PIPE
INSTALLE-ir
INSPECTOR DRAWN BY
.