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HomeMy WebLinkAboutDrain Layers Permit 455 Nevers Road 771 TOWN TH ' ; - r 0 N OF. .S�� WI NDSOR . DEPARTMENT OF POLLUTION CONTROL B/P No.: South Windsor, Connecticut , List.No.: �•�Sb�3-- DRAIN LAYER'S PERMITp 63 . , 19 Pursuant to written applicatior, permission is`hereby granted tor the Licensed Drain Layer named herein to perform the work indicated below at ZO on the side, between_ r ' at premises owned by whose address is low 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 ( j, INDUSTRIAL WASTES; Connection will be made witht ,+ _ t ,r Permit to be issued to- the holder of Drain a er's License No. Permit will expire on 19 Y P The undersigned Drain Layer hereby agrees to all the terms and'conditions.set forth on the pe'tmit and,-the re*erse side thereof. Applicant has received Town Pet'mit No. and/or C H D Permit No. for street excavation. SPECIAL CONDITIONS Signed Connection Charge Paid lleensre&Drain Layer. - Issued by + # Tax Collector Permit Fee:. Paid $ INSPECTION• Check Number: , INITIAL (Sig) FINAL (Sig) APPROVED _-9/ ,�, (Date) (Sig) ECTOR T 4 -:r a J. t t s9. e.t i tx"k S is - '�'& 3c ti �: 1. i 4.� C '�' 1.1. _ _ i:;;;: a<6 .$. i. 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