HomeMy WebLinkAboutDrain Layers Permit 77 Northview Drive TOWN OF SOUTH WINDSOR
DEPARTMENT OF POLLUTION CONTROL
B/P No.:
Li
South Windsor, Connecticut C,
st.No:: _r �
DRAIN LAYER'S PERMIT NO 1555
_ .DEG I11� / ' 19 77
Pursuant to written applicatior, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at 17 A1012—f/4 V/a .D�'f�/�� on the
side, between
at premises owned by LEV V
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 / V C,
Permit to be issued to G10VE Al C&/V.q '
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 f Licensed Drain Layer
Ih/_ Issued by
Tax Collector
Permit Fee:. Paid $
INSPECTION: Check Number:
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
(Sig)
INSPECTOR