HomeMy WebLinkAboutDrain Layers Permit Jeffrey Drive TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL
South Windsor, Connecticut
DRAIN LAYER ' S PERMIT NO 9
A4 +'gAgt 1# 19 490
Pursuant to written pplHctiAn, pe ission isgghereby granted to the Licensed Drain Layer named herein to perform
the work indicated below a t/rljA1Uq* A"s on the
—'•� side, between4 ws Air 4#04 yep4'14- tar
at premises owned by ArAtt ArAr
whose address is A Pam. A r,q
and to _ Lay House Drain, Repair House Drain, Lay Main Other
for MA"AIt49#AA • ^hMM•.Wdr*0#4A- occupancy or use,
with W Family Units, with acres.
Type of Sewage to be connected under this permit:
ANITARY S W G INDUSTRIAL WASTES, OR
Connection will be made with
Permit to be issued to SA 0j, Q&4 j
the holder of Drain Layer's License No. JtlV&, Permit will expire on.21 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 $ s, Licensed Drain Layer
(Sig) Issued by i�iuyo U 4# +(tt.�r`%01, X
Tax Collector
Permit Fee: Paid $
INSPECTION:
INITIAL (Sig)
FINAL (Sig)
APPROVED 4A I-IA44-14 eot.% (Date)
J
F. s� drAt` (Sig)
INSPECTOR