HomeMy WebLinkAboutDrain Layers Permit 5 Jeffrey Drive TOWN OF SOUTH WINDSOR
DEPARTMENT OF POLLUTION CONTROL
South Windsor, Connecticut
DRAIN LAYER' S PERMIT NO 59
19 --/C'
Pursuant to written application, permission is hereby granted to the Licrrwed Drain La�drein to perform
the work indicated below at /"cast« �0/2iy
// on @lee
at premises owned by � r, /� a•s��r
whose address is
and to Y Lay House Drain Repair House Drain, Lay Main, Other
for -,^ Z. i,.:)k, .
occupancy or use,
with Family Units, with acres.
Type of Sewage to be connected under this permit:
SANITARY SEWAG / INDUSTRIAL WASTES, OR
Connection will be made with
Permit to be issued to Si&Pwr-iv
the holder of Drain Layer's License No. 3s/960 Permit will expire on
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 $ Licensed Drain Layer
Tax Collector (Sig) issued by /V
Permit Fee: Paid $
INSPECTION: OW-01l< "6235/y
INITIAL _ ���13 — /�, / ( , (Sig)
FINAL oa�i•3/�?y - 1 4 . (Sig)
APPROVED /3 (Date)
��g2 vEy vA�/C (Sig)
INSPECTOR
3
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