HomeMy WebLinkAboutDrain Layers Permit 30 Norma Road TOWN OF SOUTH WI N DSOR --
DEPARTMENT OF POLLUTION CONTROL
_
South Windsor, Connecticut B/P No.:
List No.:
DRAIN LAYER ' S PERMIT N? 863
19
Pursuant to written applicatior, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at MIW 30 No eve CL75 on the
side, between
at premises owned by i,ira,^` 0 ffi 144. 41f
whose address is S&I"tS
and to _Lay House Drain, Repair House Drain, Lay Main, Other
for idsirloatiAl
occupancy or use,
with Z, Family Units, with acres.
Type of Sewage to be connected under this permit:
SANITARY SEWAGE (X ), INDUSTRIAL WASTES ( ), OR ( )
Connection will be made with Six 111ch Pi.an$ic blear
Permit to be issued to Ebbert 'i_ nay4n
the holder of Drain Layer's License No. A` /14'A!, 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 7
Licensed Drain Layer
Issued b ", " cjs + g
Tax Collector
Y
Permit Fee: Paid $
INSPECTION: Check Number:
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
(Sig)
INSPECTOR