HomeMy WebLinkAboutDrain Layers Permit 249 Oak Street JIMM
TOWN OF SOU
TH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL
South Windspr,:Connecticut
� l S-
DRAIN' LAYER'S PERMIT tar 402.96.p 285
19
Pursuant to written application, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at a Vic sftas-" (73
on the
side, between
at premises owned by f:
whose address is
and to N Lay House Drain, Repair House Drain, Lay Main, Other
{
for
occupancy or use,
with Family Uniks,;with acres.
Type of Sewage to be connected under this permit:
"SANITARY SEWAGY), INDUSTRIAL WASTES, OR
-
Connection will be made with "`.V
Permit to be issued to F�' "► '
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'Hermit and;the reverse side
thereof. Applicant has received Town Permit No. and/or C H D Permit No.
for street excavation.
SPECIAL CONDITIONS_ *
Signed
Connection Charge Paid ,LictAsed.Drain Layer
C. �eswti j (Sig) issued by • � �f#I1 a4 •
—�Tax Collector ,+
Permit Fee: Paid $
INSPECTION:
INITIAL (Sig)
FINAL t, (Sig)
APPROVED_ +he.*d1 149,73 (Date).
i
M•c: SIVAD Jt. (Sig)
NSPECTOR
N
4�4n
ice- —
IN 5
..5"i
NO-- S SOUTH WINDSOR POLLUTION CONTROL
LOCATION 2411Pa K s
OWNER -g)
TYPE OF WORK .S ,,����
DATE, X;L PERMIT z 85 PIPE ► UCH
INST LLER
INSPECTOR V/ ,'r DRAWN BY ° .