HomeMy WebLinkAboutDrain Layers Permit 96 Lewis Drive a_
TOWN OF SOUTH WINDSOR h .
DEPARTMENT OF POLLUTION CONTROL
South Windsor, Connecticut r
�e"�,$ B/P No.: �..Y
List No.: _ s
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DRAIN LAYER'S PERMIT Np 786
28 jimima , 19 75
Pursuant to written applicatior, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at 96 $iil" Driy* on the
W*Gt side, Me= ISOUth"itt Cr ner of Lti wiz Drive and Thom* Stre*t
at premises owned by Aftmg Z. Jim"
whose address is &"*
and to X Lay House Drain, Repair House Drain, Lay Main, Other
for •ddatiol occupancy or use,
with W Family Units, with acres.
Type of Sewage to be connected under this permit:
SANITARY SEWAGE (X ), INDUSTRIAL WASTES ( ), OR ( )
Connection will be made with "iAkQh (61.) Pl"t .0 1490 t* a lateral kNOW as StR, 4-048 at a
44pth Of E•7'+.
Permit to be issued to AdM S. Mimi i
the holder of Drain Layer's License No. 7• Permit will expire on 28 Xuvh 19 �5
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 % l
Connection Charge Paid Licensed Drain Layer
Receipt Boo 724 Issued by FxtMk J. SMith
Tax Collector
Permit Fee: Paid $
INSPECTION: Check Number:
INITIAL (Sig)
FINALT- t�^— _�,/ pall (Sig)
APPROVED _ (Date)
(Sig)
PECTOR