HomeMy WebLinkAboutDrain Layers Permit 365 Nevers Road ' + TOWN OF SOUTH' WI N DSOR
DEPARTMENT OF POLLUTION CONTROL 1.1-1i
B/P No.:
South Windsor, Connecticut
List No.:
DRAIN LAYER'S . PERM IT 653
ltl3t� 19,,' 74 -' 19
Pursuant to written applicatior, permission is hereb�y1 granted to the Licensed Drain Layer named herein to perform
the work indicated below at
on the
side, between_
at premises-owned by `I '4 C.e1.Ii
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 connected under this permit:
SANITARY SEWAGE ( , INDUSTRIAL WASTES .( ), OR ( )
Connection will be made with
=ix 1ACk 111MOtie TIP4 o
Permit to be issued to Adan Wima evski
the holder of Drain Layer's License No. *9206559 Permit will expire on 10/19/74 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 Licensed Drain Layer
Issued by
Tax Collector
Permit Fee:. Paid $
INSPECTION: Check Number: ,
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
(Sig)
INSPECTOR
r
•
0 .
i
i
-7 Z V H
NOTES SOUTH WINDSOR POLLUTION CONTROL
LOCATION 3 �.
OWNER
TYPE OP WORK
DATE r PERMIT PIPE
INSTALLERi'
INSPECTOR. DRAWN BY