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HomeMy WebLinkAboutDrain Layers Permit 408 Oakland Road = TOWN OF SOUTH WI N DSOk DEPARTMENT OF POLLUTION CONTROL South Windsor, Connecticut DRAIN LAYER''S PERMIT '© 466 ►. , 19 73 Pursuant to written apglkation, permission is hereby granted`to the Licensed Drain Layer named herein to perform the work indicated below at 0624" on the side, between at premises owned by whose address isAL # and to X ``Lay House Drain, Repair House Drain, Lay Main, Other . for occupancy or use, Y, , with Family Units,with acres. Type of Sewage to be connected under this permit: (SANITARY SEWAGE) INDUSTRIAL WASTES, OR Connection will be made with 4121004046 t") yam:. 31 Permit to be issued to »* sum the holder of Drain Layer's License No. " Permit will expire on 19 . The undersigne&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 W 100k= 40WO Signed Connection Charge Paid . Licensed Drain L yer Tax Collector (Sig) Issued by �� ►► Permit Fe Paid $`1 ' INSPECTION: INITIAL !,i ig) FINAL tj (Sig) aw APPROVED - [/YR� -yr (Date) (Sig) 7 i I t NOTES SOUTH WINDSOR POLLUTION CONTROL LOCATION OWNER r TYPE OF WORK DATE fK .'r PERMIT 44' PIPE 7 777 7 INSTALLER - INSPECTOR DRAWN BY