HomeMy WebLinkAboutDrain Layers Permit 107 LeFoll Boulevard TOWN OF SOUTH WINDSOR
DEPARTMENT OF POLLUTION CONTROL
B/P No.:
South Windsor, Connecticut
List.No.: _ API C?
DRAIN LAYER'S PERMIT NO 1936
2-`2 , 19 7?
Pursuant to written applicatior, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at id 7- 3 /��.�� � /� �D�y 6—� on the
side, between
whose address is
and to Lay House Drain, epair House Drain, Lay-Main, Other c
for occupancy or use,
with �Q Family Units, with
er� acres.
Type of Sewage to be connected under this permit:
SANITARY SEWAGE ( ), INDUSTRIAL WASTES ( ), OR ( )
Connection will be made with !Y
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
Signed
Connection Charge Paid �f. �� Cl.12 Licensed Drain Layer
Issued by c
Tax Collector
Permit Fee:. Paid $
INSPECTION: Check Number:
INITIAL (Sig)
-- - FINAL — (Sigh- - - ------ ---- ---
APPROVED Z- (Date)
e (Sig)
INSPECTOR
-3-7
1