HomeMy WebLinkAboutDrain Layers Permit 85 Highland Drive (2) TOWN OF "SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL B/P No.: _
South Windsor, Connecticut
3 List No.:
DRAIN LAYER'S PERMIT p 610
19;4
Pursuant to written applicatior, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at 'ter ' w on the
C f side, between .--h-IM :bnti j A&- =t�,
at premises-owned b -. ,k `
whose address is
and to '` 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 liX s E «ii•
Permit to be issued to_ a v,(' *
the holder of Drain Layer's License No. A4y4f,.i.-• i-sl Permit will expire on AVA14�
The undersigned Drain Layer hereby agrees to all the terms and conditions set forth on pUrmft
the reverse s dl e
thereof. Applicant has received Town Permit No. and/or C H D Permit No.
for street excavation.
SPECIAL CONDITIONS au:a t
Signed
Connection Charge Paid s a '., Licensed Drain Layer
Issued by4�a
Tax Collector
Permit Fee: Paid $
INSPECTION: Check Number:
INITIAL _. r (Sig)
f.
FINAL (Sig)
APPROVED (Date)
R.,
(Sig)
INSPECTOR