HomeMy WebLinkAboutDrain Layers Permit 258 LeFoll Boulevard ' rov yl+.Y+ti.{ram:<yt�sRry7t.r"L� wr'S*',o!sfi
TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL B/P No.:
South Windsor, Connecticut
List.No.: _
DRAIN LAYER'S PERMIT NO 3111
2,1;7
, 19�-3
iPursuant to written applicati r, permission-i�sphereby nntted to the 'ce sed Drai Layer named herein to perform
the work indicated below at f� d 7 0`� �� on the
side, between
at prt-m;.qt-.q owned b3l
whose address is
and to Lay House Drain, Repair House Drain, Lay-Main, Other ,
for occupancy or use,
with Family Units, with acres.
Type of Sewage to be connected under this permit:
' SANITARY SEWAGE ( j, 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
g / d� Signed y
Connecti har a Paid Licensed Drain Layer
Vd/xt/ A?L4., Issued by
Tax Collector
Permit Fee: Paid $
INSPECTION: Check Number: SS'O
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
(Sig)
— - -- INSPECTOR