HomeMy WebLinkAboutDrain Layers Permit 14 Lewis Drive TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL
B/P No.:
South Windsor, Connecticut 3 -f—
List.No.: _6
DRAIN LAYER'S PERMIT N? y 1548
,pLc�,6 ex y , 19��
Pursuant to written application,/permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at / 7 .l�Y1//.S I-PR 1 yle�_ on the
side, between
at premises nwned b_V 'Ed
whose address is
and to _ Lay House Drain, Repair House Drain, Lay Main, Other
for 12estpeNT//4L` occupancy or use,
with 0IV6— Family Units, with acres.
Type of Sewage7).
connected under this permit:
SANITARY SEWAGE INDUSTRIAL WASTES ( ), OR ( )
Connection will be made with �✓!�'�
Permit to be issued to &YOW %C
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 IaZ9 3 iLicensed Drain Layer
Issued by
Tax Collector /tom
Permit Fee Paid $ 16✓6
INSPECTION: Check Number: --
INITIAL (Sig)
FINAL � ���� (Sig)
APPROVED_ > �-� '� (Date)
(Sig)
INSPECTOR
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