HomeMy WebLinkAboutDrain Layers Permit 186 Hillside Drive <' TOWN OF SOUTH WI N DSOR
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DEPARTMENT OF POLLUTION CONTROL B/P No.:
South Windsor, Connecticut
List No.: _
DRAIN LAYER'S -PERMIT NO 2167
, 19 �
Pursuant to written applicatior,j,/permission 's hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at �.�I ��' //�%�t` Ar on the
side, between
at premises owned by—
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
Permit to be issued to
the holder of Drain Layer's License No. 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
/ 7 3 (/11
C nnection Charge Paid �Qo Signed Licensed Drain Layer
0- L=ttiz-l�'-t/
Issued by
Tax CpLeeeer p7�(l Vaid
/a f D
Permit Fee: $ lS
INSPECTION: Check Number:
INITIAL (Sig)
FINAL (Sig)
(Date)
-
INSPECTOR -
LEONARD CONCRETE PIPE CO., INC.
375 MATHER ST.-HAMDEN,CONN.06514-(203)281-3366
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