HomeMy WebLinkAboutDrain Layers Permit 199 Kelly Road (2) ' - TOWN -'OF , SOUTH WINDS R
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DEPARTMENT OF POLLUTION CONTROL
South Wind"r, Connecticut
DRAIN LAYER'S PERMIT N0 325
Pursuant to written application, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at 199 1;634 J6#A tr-jjt- y on the
side
at premises owned by
whose address is �..r.
and to '_Lay House Drain, Repair House Drain, Lay Main, Other
forurtaia fir! occupancy or use,
with Family Units, with acres.
Type of Sewage to be connected under this permit:
c SANITARY SEWAGI), 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 t 19 _
The undersigned Drain Layer hereby agrees to all the terms and conditions set forth on the perms and the reverse side
thereof. Applicant has received Town Permit No. and/or C H D Permit No.
for street excavation.
SPECIAL CONDITIONS xl Us tofto
Signed..
Connection Charge PaidjK_ff_#3f Licensed Drain Layer
' 36 H#.s (Sig) Issued by_ � 301IM3260- Gr
Tax Collector
Permit Fee: Paid $j&Y
INSPECTION:
INITIAL �e " (Sig)
FINAL _ (Sig)
APPROVED—_4031 �'�r1 (Date)
t
(Sig)
'� fII�? ECTOR g)
,. lp
N
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NOTES SOUTH WINDSOR POLLUTION CONTROL
n1oT Tp LcALE LOCATION 1 99
C'n-Lu i2wb l4or da
OWNER o S
0 TYPE OF WORK
p s 3®,4 DATE o -o9- 3 PERMIT 3 Z S PIPE 4
INSTALLER LA -
INSPECTOR DRAWN BY