HomeMy WebLinkAboutDrain Layers Permit 24 Jeffrey Drive TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL
South Windsor, Connecticut
DRAIN LAYER ' S PERMIT
O 58
19
Pursuant to written applicatio p ission s hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at ,rF: r s , Lr �, on the
side, between
at premises owned by
whose address is '?r J
and to X Lay House Drain, Repair House Drain, Lay Main, Other
for Z4.4 occupancy or use,
with Family Units, with A 0 acres.
Type of Sewage to be connected under this permit:
SANITARY SEWAGE, INDUSTRIAL WASTES, OR
Connection will be made with ;P
Permit to be issued to "ell4*
the holder of Drain Layer's License No. / ' ' Permit will expire on A,,,eOA j: 7 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 - `•tea-y t d rs> q A- 4of
Signed_z dt
Connection Charge Paid $ /44Q T L censed Drain Layer
� (Sig) issued by
Tax Collector �.,P"�d:• �' �,c: �+,#� " ,,�
Permit Fee: Paid $ low
INSPECTION: 01io le_
INITIAL (Sig)
,d�f ! ;.
FINAL t�./ tL (Sig)
APPROVED +op " (Date)
(Sig)
INSPECTOR
I'VE!xi Aveirue
64
A. F, reaslee
24 Peas l®�
—24--pgals lee.-Dri
A "Oca d
Assessor's Records : Volume 48 Uage 279
Subdivision ion- - assessment computed separ atlly)
13
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No
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5%
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