HomeMy WebLinkAboutDrain Layers Permit 52 Hollis Road (2) .. . TOWN OF SOUTH WIN DSO
DEPARTMENT OF POLLUTION CONTROL
South Windsor, Connecticut
B/P No.:
List 1Vo:: or
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DRAIN LAYER'S P
x� ERMIT._ o 7 55
119
Pursuant to written application permission is herby granted to the Licensed Drain Layer named herein to perform
the work indicated below at. J" RAI" amt on the
S
side, betweenr. T
x
at premises owned b
whose address is ff
and to + Lay'House Drain, Repair House Drain, I, ty;Main, Other,
for .rrr_A.a '
occupancy or use,
with Family TTnits, With
acres.
Type of Sewage to be connected under this permit:
SANITARY SEWAGE (X), INDUSTRIAL WASTES _( ) OR
_ Con_-nection,will,,kp.made with_ ��_ alm" saw
Permit to be issued to #0swum
the holder of Drain Lal Permit Will expire`on 19
yer�'s=License No. `i��
;'Fhe undersigned Drain Laker hereby agrei to all the terms,and conditions set forth on the permit and the reverse side
f.
thereof. Applicant has received Town Permit No. and/or C If Permit No.
for street excavation.
SPECIAL CONDITIONS
Signed
Connection Charge Paid � ✓ icens Drain,Layer_
Issued by
Tax Collector
Permit Fee:. Paid ;
INSPECTION: Check Number: .
•1 ,
L z i (Sig)
FIN
APPROVED_ (Date)
(Sig) -,�—