HomeMy WebLinkAboutDrain Layers Permit 200 Kelly Road r - TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL gip No.: �" E
South Windsor, Connecticut
List No.: _S6o 17
.37r DRAIN LAYER'S PERMIT �O "f 96
/. iraa uAm d , 19
Pursuant to written app icatior, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at ZGQ 1 044 Y /20A p on the
0404114 side, betweenlOAu. Sirt4et i L. LAL t.. Sra ET
at premises owned
whose address is 4A.,119
and to i+' Lay House Drain, Repair House Drain, Lay Main, Other
for A4Ff144&N714,t.r occupancy or use,
with 094V Family Units, with acres.
Type of Sewage to be connected under this permit:
SANITARY SEWAGE (*/), INDUSTRIAL WASTES ( ), OR ( )
Connection will be made with 4 g44,4,1r4PC- AIAO' TD A 4A "44. 1Z*We,•A/AI 4 SS
A
Permit to be issued to. A A 4-V S eyll
the holder of Drain Layer's License No. dg- Ze-&/$E Permit will expire on 13 A0,2
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
f Signed _
Connection Charge /Paid Licensed Drain sayerAft —
AlOv 7�A Issued by
1 Tax Collector
Permit Fee: Paid $ _1 0.42
INSPECTION: Check Number:
'.
INITIAL (Sig)
FINAL a b{ (Sig)
+ APPROVED44, (Date)
(Sig)
ECTOR