HomeMy WebLinkAboutDrain Layers Permit 130 Northview Drive T
TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL
South Windsor, Connecticut
6, S-
DRAIN LAYER 'S PERMIT X0 44
Z , 1 4Si
Pursuant to written application, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at /. T �` ! Ik;O�'t L 4s)
;� on the
�1y►
side, between
at premises owned +16�t Ss rtra► � + �1 �� � �'
whose address is r&VI& &O�4#IJAr
and to —)(--Lay House Drain, Repair House Drain, La Main,, Other
for 4#&flbWellnA&.
occupancy or use,
with !!�!� "�' Family Units, with d�y
acres.
Type of Sewage to be connected under this permit:
ITA Y S WAG INDUSTRIAL WASTES, OR
Connection will be made with 4& +� g y gore
Permit to be issued to +1 t • .+ Iis
the holder of Drain Layer's License No.(09�r 24rfv 2 Art Permit will expireIV n o 1
QA
The undersigned Drain Layer hereby agrees to all the terms and conditions set forth on the permit an th reverse skid
thereof. Applicant has received Town Permit No. and/or C H D Permit No.
for street excavation. n
SPECIAL CONDITIONS l't w i l`•y r.:�� ��v-r�E'� tAN
Signed
Connectionu
Charge Paid $ Licensed Drain Layer
� Tax Collector (Sig) issued
Permit Fee: Paid $/,*"'moo
INSPECTION: O-VAWOO(*4#. 0/7
INITIAL i�f/IA 4
(Sig)
FINAL (Sig)
APPROVED
(Date)
INSPEC OR (Sig)
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