HomeMy WebLinkAboutDrain Layers Permit 1512 Main Street TOWN OF SOUTH WINDSOR
/ DEPARTMENT OF POLLUTION CONTROL
B/P No.:
South Windsor, Connecticut
List.No.: 5—�-
- _D_RAIN- LAYER'S PERMIT _ -
- --- ---------
N° 1880
, 197 2_
Pursuant to written applicatior, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below
at St-on the
side, between
at premises owned by
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 beconnected under this permit: /,7_./'Yh�
SANITARY SEWAGE (v), 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
Connect* Charge Paid y�U Licensed Drain L er
F19 r19�
- Issued by
Tax Collector /d /
m V`e^y Permit Fee: Paid $ l
INSPECTION: Check Number: . a yob
INITIAL (Sig) I
FINAL (Sig) C o
APPROVED (Date)
-_ INSPECTOR (Sig)
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