HomeMy WebLinkAboutDrain Layers Permit 47 LeFoll Boulevard ...TQWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL
B/P No.:
South Windsor, Connecticut
List.No.: _ 2 2 0
DRAIN LAYER',S PERMIT NO 1825
19
Pursuant to written applicatior, permission is hereby granted to the 'tensed Drain Layer named herein to-perform
the work indicated below at ,aC/�f} _
Z -'�f on the
C side, between
at premises owned by All EJ
whose address is r
and to Lay House Drain, Repair House Drain, Lay-Main, Othe
for Per occupancy or use,
with 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
Signed Z
CCgnnt tion vCharge Paid •t7�� Licensed Drain Laye
- u# -
Tax Collector Issued by 00
Permit Fee: Paid $
INSPECTION: �eck Niube ��a
_, _r
INITIAL (Sig)
FINAL (Sig)
— APPRDYED — --- --- -------
(Sig)
ate-� ---- --- - ---
SPECTO
-
I
7i
i
i
J
i
NOTES SOUTH WINDSOR POLLUTION CONTROL
LOCATION e
OWNERo
TYPE OF WORK
DATE ' . PERMI p E 'f
INSTAMERL,
INSPECTO DRAWN BY