HomeMy WebLinkAboutDrain Layers Permit 86 Juniper Lane TOWN OF SOUTH WINDSOR
i DEPARTMENT OF POLLUTION CONTROL
South Windsor, Connecticut B/P No.:
List No.: _ 7
DRAIN LAYER'S PERMIT NO 1535
NDV�ni� 2 , 19 7:z9
Pursuant to written applicatior, permission is hereby granted to the Licensed Drain Layer named herein to perform
the-work indicated below at R G 1 V N 1?8_1Z LA. L.6T 19
on the
side, between
at premises owned by �
whose address 1s.
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
Signed
Connection Charge Paid Licensed Drain Layer
Issued by
Tax.Collector
Permit Fee:. Paid $
INSPECTION: Check Number: , -5'06 9V
INITIAL (Sig)
FINAL (Sig)
APPROVED _ _ L�2 � spate
(Sig)
nor t`l
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