HomeMy WebLinkAboutDrain Layers Permit 75 Highland Drive TOWN OF SOUTH ; W I N DSOR
DEPARTMENT OF POLLUTION CONTROL
South Windsor, Connecticut
DRAIN LAYER'S PERMIT
O 266
4 AwIr'fl'A
Pursuant to written application, permissions is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at Q A A AJ J .b.4#y 4r (Lor 94) on the
5 side, between t.rf�f,gi trt 11,owl. O ca k $i
at premises owned b w '" C S tt✓F.✓
whose address is—
and to 161�Lay House Drain, Repair House Drain, Lay Main, Other
for occupancy or use,
withr Family Units, with acres.
Type of Sewage to be connected under this permit:
(SANITARY SEWAGE, INDUSTRIAL WASTES, OR
Connection will be made with
Permit to be issued to . - ; in, '`J
the holder of Drain Layer's License No. 44J 91 a ' % €i t1 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.
f
SPECIAL CONDITIONS `
r
Signed
Connection Charge Frld $ f �. -�� Licensed Drain Layer
`' ?e n1 F (Sig) Issued by „ 471
Tax Collector
Permit Fee: Paid $ 14
INSPECTION: pl °V '
INITIAL (Sig)
FINAL (Sig)
APPROVED ! 9 J tAfoe 1973 (Date)
Cr tTCAD JIV (Sig)
INSPECTOR
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NOTES SOUTH WINDSOR POLLUTION CONTROL
LOCATION q �=
OWNER Cz C-
TYPE OF WORK
DATE PERMIT PIPE
INSTALLER
INSPECTOR DRAWN BY