HomeMy WebLinkAboutDrain Layers Permit 116 LeFoll Boulevard TOWN OF SOUTH WINDSOR
DEPARTMENT OF POLLUTION CONTROL
South Windsor, Connecticut B/P No.:
6
List No.: _
DRAIN LAYER"S PERMIT NO 1934
I(' L_e lI &vd , �// z7 , 1�
Pursuant to written applicatior, permission is hereby gra a to the Licensed Drain Layer named herein to perform
the work indicated below at Z on the
ide, between
at premise ow d by �/lA A ,/&"'d
whose address is
and to Lay House Drain, Repair House Drain, Lay Main, Other
for '
occupancy or use,
with t2:2a Family Units, with acres.
Type of Sewage to be connected under this permit: ,.
SANITARY SEWAGE ), INDUSTRIAL WASTES ( ), OR ( )
Connection will be made with D ��Cyr-
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
t/L'y17-7
Signed
Connection Charge Paid 4/00 OU C6_, Licensed Drain Layer
Id
O /�YYl� Issued by
Tax Collector
Permit Fee: Paid $
INSPECTION: Check Number: ,/1�yw
INITIAL (Sig) —r, M c'`_
FINAL (Sig)
- --------------------
PPROVEIf--- _-- (Date)
INSPECTOR (Sig)