HomeMy WebLinkAboutDrain Layers Permit 222 Norton Lane TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL
B/P No.:
South Windsor, Connecticut
List.No.: 2—��
DRAIN LAYER'S PERMIT NO 1869
Pursuant to written applicatior, permission is hereby granted to the Lice ed Drai Layer named herein to perform
the work indicated below at yj zCL on the
side, between r
at premises owned by L AA
c
whose address is
and to Lay House Drain, Repair House Drain, Lay-Main, Other
for � � occupancy or use,
with Family Units, wit acres.
r
Type of Sewage to bee nected under this permit:
SANITARY SEWAGE ( ✓ , INDUSTRIAL WASTES .( ), OR ( )
Connection will be made with //e
Permit to be issued to
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
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9�ai/7 9
*/�-)j Signed
Connection Charge Paid Q,0 C) Licensed Drain Layer
�l� I 1
Issued by
. Tax Collector ler�;Ijt
Fee:. Paid $ b 0__
b INSPECTION: Check Number:
Aik/*7 �-
INITIAL (Sig) t0�3S ,V0 c 1 o 4
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FINAL (Sig) T+YV
APPROVED (Date)
INSPECTOR (Sig)