HomeMy WebLinkAboutDrain Layers Permit 194 Kelly Road TOWN OF SOUTH WINDSOR
DEPARTMENT OF POLLUTION CONTROL
B/P No.:
South Windsor, Connecticut SCoo�16
List.No.: _
DRAIN LAYER'S PERMIT N0 869
n rye__ , 19
Pursuant to written applicatior, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at -1 04 i(aj l v r4nmj,, on the
side, between
at premises owned b
whose address is Ej
and to x Lay House Drain, Repair House Drain, Lay Main, Other
for al occupancy or use,
with Gas Family Units, with acres.
Type of Sewage to be connected under this permit:
SANITARY SEWAGE ( X), INDUSTRIAL WASTES ( ), OR ( )
Connection will be made with x TUC—r, ,)i;u_,,+j o N; l,M
Permit to be issued to �t.,,._rard
the holder of Drain Layer's License No. 20'S/451 _ 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 y u.0? Licensed Drain Layer
6/17/75 Issued by F rwt J. Ujnith
Tax Collector
Permit Fee: Paid $ ____.ni .00
INSPECTION: Check Number:
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
INSPECTOR (Sig)