HomeMy WebLinkAboutDrain Layers Permit 78 Old Farm Road TOWN O p
:SOUTH W1 N DS0R
DEPARTMENT OF POLLUTION CONTROL e
B/P No.:
South Windsor, Connecticut
L$t No. 4
DRAIN LAYER'S' PERMITO 26
-87
Pursuant to written applicatior, miss on is hereb r ed to the, Drain Layer named herein to"perform
/n
he work'indicated below at on the:
side, betty en s
At premises owned by
k
` whose address is
and to Lay House Drain, Repair House Drain, I,ay Main, _TOthef
for
occupancy or use;
K with ; Family.Units, with. acres.
Type of Sewage to be connected under this permit:
SANITARY SEWAGE ( ), kNLTSTRIAL WASTES .( ), OR
Connection will be made with _ -
W
Permit to be issued ta;.. .
the holder of Drain Layer's License No. ermt wi expire on 19
The undersigned Drain Layer he eby ngre s to all,the,terms an con itions set forth oci'rhe permit hnd t 't verse side
thereof. Applicant has received Town Permit No. `` and/or H-`D Permit
for street excavation.
SPECIAL-:CfONDITIONSt
�.•�„f)��'/jam/- - -�u• - -
Signed
Connection Charge Paid %D U �-,•Licensed•Drainj.ayer
h/LN,I e J�i�t
Issued by -
Tag Collector
Permit Fee:. Paid .$ -,dd
INSPECTION: Check Number: - �
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)..
('ig)
INSPECTOR