HomeMy WebLinkAboutDrain Layers Permit Newberry Road TOWN OF ,- �()UV WI N DSOR
DEPARTMENT OF POLLUTION CONTROL
B/P No.: _
South Windsor, Connecticut
List No.: - f.
DRAIN LAYER ' S PERMIT No 532
Harrok 29 , 1974
Pursuant to written applicatior, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at :it y-,12 r? ` -tj s t i P.a lee Nywber lei•
on the
yCxrt-,I side, between X' psi !1i.g.wzy
at premises owned by "." '•'
whose address is a SWO
and to Lay House Drain, Repair House Drain Lay Main, Other Consereiarl ,
for occupancy or use,
with Family Units, with acres.
Type of Sewage to be connected under this permit:
SANITARY SEWAGE (-{ �; INDUSTRIAL WASTES ( ), OR ( )
Connection will be made with '•ItkStiC I)JVC
Permit to be issued to 11,%bert L.
the holder of Drain Layer's License No.Wq-,?0". 5 Permit will expire one fit} 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. 73
for street excavation.
SPECIAL CONDITIONS
Signed,
Connection Charge Paid ;�7��7h1i Licensed Drain Layer
Per. Issued by Jr,
Tax Collector
Permit Fee: Paid $
INSPECTION: Check Number: 1l-k4 _
INITIAL Of/*,#At 114W , 44 14'I j (Sig)
g
FINAL (Sig)
APPROVED , ; (Date)
(Sig)
INSPECTOR I r,•'
N
t°
0 G
NOTES SOUTH WINDSOR POLLUTION CONTROL
LOCATION
OWNER
TYPE OF WORK �,�
DATE PERMIT S� PIPEe� t Svc,
INSTALLER i-L
INSPECTOR r-,�X DRAWN BY ��