HomeMy WebLinkAboutDrain Layers Permit 100 Northview Drive TOWN OF SOUTH WI N DSOR
i q ! DEPARTMENT OF POLLUTION CONTROL
South Windsor, Connecticut
DRAIN LAYER'S PERMIT N? 53
19A_
Pursuant to written application, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at A16710y1^4 �j�,L 9�8 on the
�°t�a ii side bin f4+I ,14r?tt 1-2 o`Atf0* Iv, 01A44 � Oltb
at premises owned by AV& 0P i&ji
whose address is lgja &Ii muAlldrAJ 0-44-
and to _ Lay House Drain, Repair House Drain, Lay Main, Other
,
for Is@*S l rAo1►A& occupancy or use,
with AkdA' EJ) Family Units, with 0* yr acres.
Type of Sewage to be connected under this permit:
ANITARY SEWAGE, INDUSTRIAL WASTES, OR
Connection will be made with 46401k It*r
Permit to be issued to ! N �i) �S A#M1
the holder of Drain Layer's License No.-Aj• Permit will exp a on 040 of 19
The undersigned Drain Layer hereby agrees to all the terms and conditions set forth on the permit and the rfverse side
thereof. Applicant has received Town Permit No. and/or C H D Permit No.
for street excavation.
SPECIAL CONDITIONS '*�' f
Signed
Connection Charge Paid $y Licensed Drain Layer
Collector
(Sig) issued by lz_t",494�2
Tax C
Permit Fee: Paid $
INSPECTION: At j #04re K �' �• �� "�
INITIAL (Sig)
FINAL ��3 -�+f�a w. (Sig)
APPROVED �.3 .�' C•r „r� /gbcj (Date)
Al �#J. I� �St'�t (Sig)
INSPECTOR
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1�i.✓����� i1�=sesa
Cull
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71 t
11
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Psvey, Robert H. &: Harriet E.
100 NQCthvL wr Drfvs
Sam
S1 69 125
94 258.9
A-20 _ RealdeutLal
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a,
116
8.50 986.00
1 200.00 200.00
1186.00
X
X _
3 400.00 400.00
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