HomeMy WebLinkAboutDrain Layers Permit 96 LeFoll Boulevard TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL
B/P No.:
South Windsor, Connecticut
List No.:
DRAIN LAYER'.S PERMIT - 6/92/
N° 1942
b1v , 19�
d
Pursuant to written appliica-tior, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at f�G` c�f el—e on the
side, between
at premises;owned by m• � �
whose address is
and to Lay House Drain, Repau House Drain, Lay Main, Other
for /fx occupancy or use,
with F' 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
V3o� -7
0 o Signed
Connection Charge Paid (oa Li se7Drain yer
Issued by
Tax Collector
Permit Fee: Paid $ _UV
INSPECTION: Check Number: f`" 2 /
INITIAL (Sig) /{ k-),7
FINAL n
----APPROVED --- - ------------(Date)---- oVi3 u,-
INSPECTOR (Sig)
N
it
1 p
Oil
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NOTES SOUTH WINDSOR POLLUTION CONTROL
LOCATION a
OWNER
TYPE OF WORK
DATE PERMIT PIPE �s
INSTALLER(
IN PECTOR DRAWN BY