HomeMy WebLinkAboutDrain Layers Permit 259 Oak Street TOWN OF SOUTH WI N DSOR
4
DEPARTMENT OF POLLUTION CONTROL ., F
_
South Windsor, Connecticut B/P No.:
List No.: _S i
�'c �7
DRAIN LAYER'S PERMIT Na 894
'17 j T t- 119
Pursuant to written applicatior, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at t,;; , - `j on the
side, between _ .,�
at premises owned by
whose address is `"' ``"
r
and to Lay House Drain, Repair House Drain Lay Main, Other
for
occupancy or use,
with " y Family Units, with acres.
Type of Sewage to be connected under this permit:
SANITARY SEWAGE (X10, INDUSTRIAL WASTES ( ), OR
Connection will be made with Gilt--3 ".'.v ja 3 tex 3: 1'tq''t3 t;
Stave 7+39.3, qt a depth of 6.5'-.
Permit to be issued to
the holder of Drain Layer's License No. Permit will expire on ;; -�:_ e4br,� e�t• 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 11 l
Connection Charge Paid `fit Licensed Drain'Layer
Issued by 1101,4,.. :.: r:v,s•a.::,
Tax Collector
Permit Fee: Paid $
INSPECTION: Check Number:
INITIAL >''��7 0915 � (Sig)
FINAL (Sig)
APPROVED (Date)
INSPECTOR (Sig)