HomeMy WebLinkAboutDrain Layers Permit 45 Hollis Road (2) TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL Bhp No.:
South Windsor, Connecticut
List.No.: _
DRAIN LAYER'S PERMIT O 765
� �1174 1,19
Pursuant to written applicatior, permission is hereby granted to the Licensed Drain Layer named herein to-perform
the work indicated below at on the
side, between
at premises owned by Victor N. Legiow
whose address is
and to Lay House Drain, Repair House Drain, Lay-Main, - . Other
for
occupancy or use,
with Oar Family Units, with acres
Type of Sewage to be connected under this permit:
SANITARY SEWAGE (X), INDUSTRIAL WASTES .( ),�OR ( )
— - --Connection will be made-with -- Six IR6b_P1" _i-°ftP*. -1 --
Permit to be issued
.to
the holder of Drain Layer's License No.�1' 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
Signed
Connection Charge Paid 6V Licensed Drain Layer.
9t#/ Issued by V J. II
Tax Collector
15.0 3
Permit Fee:. Paid $
INSPECTION: Check Number: ,
INITIAL (Sig)
FINAL (Sig)----
APPROVED i.7/;l 17A (Date)
(Sig)
INSPECTOR
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