HomeMy WebLinkAboutDrain Layers Permit 110 Northview Drive � r
• j{ TOWN OF SOUTH WINDSOR
DEPARTMENT OF POLLUTION CONTROL
South Windsor, Connecticut
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1 DRAIN LAYER'S PERMIT N? 40
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Pursuant to written application, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at II If j4e&"i M V;&T`,A0 i V4r 4 7) on the
�it9u! 1 M side, between% 4 j,SROAb I ALk,*1.4, WAatarif
at premises owned by #Ll tom! r7►lAI�G�
whose address is 1#*A 'ts#*d 'bJ.IVA
and to _ Lay House Drain, Repair House Drain Lay Main Other
for ikioffi/ iTiON"
occupancy or use,
with 0 #4 4F C4 Family Units, with acres.
Type of Sewage to be connected under this permit:
SANITARY SEWAG INDUSTRIAL WASTES, OR
Connection will be made with At rf 4,,,
Permit to be issued to 21e ilk j .bMis i# + "t'l t y f1 f'�Vpat
the holder of Drain Layer's License No._01-3M,.ri_s Permit will expire ont j „ #J40 it 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 tJL ,�1/ /�(� l i �...�./ 3
Connection Charge Paid $44w%dkp Licensed Drain Layer
209f A?rAC F4&b (Sig) isstre'd`"liY
Tax Collector
Permit Fee: Paid $
INSPECTION: Vossa C*+ '*. Ito. 14ro
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
(Sig)
INSPECTOR
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