HomeMy WebLinkAboutDrain Layers Permit 151 Jacques Lane TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL Bhp No.:
South Windsor, Connecticut
List.No.: _
DRAIN LAYER"S PERMIT �� 3192
/J
• �Q `l ' `i , 19
�a c l. �
Pursuant to written applicatior, ermission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at 164v Q d-kk, on the
side, betwe n
at remises owned b 1. ".a` 5
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
I ' 6 Cl l Signed
Connection Charge PaidLf.UO,D l `f O`1 Licensed Drain Layer
lI
Issued by -h. .� Collector U�� _ n
L(� Gt-Y Permit Fee: Paid $l�_1L
INSPECTION: Check Number: ��
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
-
INSPECTOR