HomeMy WebLinkAboutDrain Layers Permit 108 LeFoll Boulevard TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL
B/P No.:
South Windsor, Connecticut List No.. Z
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DRAIN LAYER'S PERMIT NO 1933
UO /! / 2- 7 , 19 7j
Pursuant to written applicatior, permission its hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at ///( Z' a on the
side, between
at premises owned by
whose address is
and to Lay House Drain, Repair House Drain, Lay-Main, Other
for
,, A ooccupancynorncP
with !!�Yl�Family Units, with '
acres.
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Type of Sewage to be connected under this permit:
SANITARY SEWAGE (!�), INDUSTRIAL WASTES ( ), OR ( )
Connection will be made with �( /-•�C
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
00 7� Signed
Connection Charge Paid 450a. Licensed Drain Layer
CZ�Z,V& Z / Z
Issued by
Tax Collector
Permit Fee:. Paid $ _ / _UO
INSPECTION: Check Number: , Ao VI(
INITIAL (Sig) .�r M cr
FINAL (Sig) 40
---APPROVED— - --- - - - - (}— -- -- — f — ---
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(Sig)
INSPECTOR
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NOTES SOUTH WINDSOR POLLUTION CONTROL
LOCATION L. Z
OWNER AA
TYPE OF WORK
DATE &Ai4a PERMIT PIP
INSTALF R g IL 0 a a-A-A4 1,
INSPECTOR DRAWN BY