HomeMy WebLinkAboutDrain Layers Permit 186 Kelly Road (3) TOWN OF SOUTH WI N DSOR #
DEPARTMENT OF POLLUTION CONTROL
{ South Windsor, Connecticut
2-60204)
DRAIN LAYER'S PERMIT N? 295
Ir 19
Pursuant to written application, permission is
hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at 116 '', on the
/�'t M ith side, between dW
at premises owned by
whose address is F°
and to Lay House Drain, Repair House Drain, Lay Main, Other
for •` occupancy or use,
with Q 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 ,l
The undersigned Drain Layer hereby agrees to all the terms and conditions set forth on the per ^t and the reverse side
thereof. Applicant has received Town Permit No. and/or C H D Permit No.
for street excavation.
SPECIAL CONDITIONS-- -:fi .';,a .; •:, 11
r+ { s
Signed r'•' .p `�a r
Connection Charge Paid,A�l g r� Licensed Drain Layer
w.q ;' ,./:t: (Sig) issued b
Tax Collector
Permit Fee: Paid
INSPECTION:
INITIAL 10 f (Sig)
If
FINAL ` (Sig)
APPROVED ) (Date)
(Sig)
INSPECTOR
N
36 ! / t5
3'
�_ G�rG.J Gc,`t l 1�6c.r tiJ
�/36
e
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NOTES SOUTH WINDSOR POLLUTION CONTROL
LOCATION le 6 p
OWNER gagger Q
TYPE OF WORK gcgao
DATE 6 22 7 3 PERMIT 29s' PIPE " P.v. C.
INSTALLER LAmaw
INSPECTOR MS DRAWN BY /4 S