HomeMy WebLinkAboutDrain Layers Permit 70 Meryl Road TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL
South Windsor, Connecticut B/P No.:
List No.: _
DRAIN LAYER'S PERMIT NO 2551
19
Pursuant to written applicatior, permission is ereby anted to the Licensed Drain Layer named herein to perform
the work indicated below at Z 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 be onnected under this permit:
SANITARY SEWAGE ( ), INDUSTRI L WASTES .L ), OR ( )
Connection will be made with 6 (2
Permit to be issued to �i✓L
�7 7
the holder of Drain Layer's License No. � / ?�1 Permit will expire on /t� / 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
6 �2 -cPy
Signed
—2��7 �/w
Connection Charge Paid Licen ed Drain er
Issued by-
Tax Collector J�
Permit Fee: Paid $ _Z �.L�
INSPECTION: Check Number:
INITIAL (Sig)
FINAL (Sig)
APPROVED Z 571 (Date)
(Sig)
INSP CTO
, V
e
P�OTES SOUTH 14INDSOR POLLUT
ION QOWROL
LOCATION
OWNER f%
TYPE 0 WORK �-71;.
r
DATE - '- � s- _"' PEPRt�fIT < a � v PIPE
t .
INSTALLER 17
INSPECZOR DRAWN BY