HomeMy WebLinkAboutDrain Layers Permit 70 Mohegan Trail TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL BAP No.:
South Windsor, Connecticut
.. List No.:
DRAIN LAYER'S PERMIT N? 912
19
Pursuant to written applicatior, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at Lst 11 Grada 211 74/16-11r-4-/ 7,—")c, on the
side, between
at premises-owned by
TAX
whose address is
and to Lay House Drain, Repair House Drain, Lay Main, Other
for ) #.dal occupancy or use,
with Og! Family Units, with acres.
Type of Sewage to be connected under this permit:
SANITARY SEWAGE (X), INDUSTRIAL WASTES .( ), OR
Connection will be made with A4Ir lw& 1t1arill' 1�i�i
Permit to be issued to Je Co X '
IWQ. �j/1g1
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 Ir.8E9 t Licensed Drain Layer
7/9V" Issued by J» Wth
Tax Collector
Permit Fee: Paid $ 15e00
INSPECTION: Check Number:
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
(Sig)
INSPECTOR