HomeMy WebLinkAboutDrain Layers Permit 190 Old Farm Road v7
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4r TOWN OF z'SOCITH WINDSOR
DEPARTM tjT OF POLLUTION CONMOL gip No.:
4 K: :$Quth.Windsor, Connecticut
List'.No.:
DRAWLAYER'.;S PERMIT
Old , Rd
PurquAni to'writt. n a licatior permission is he ran ed r the Licensed Drain La er named herein to" erform
P P y g 4e y p
the work Indic eeA`:bel6w at "L1 ! 'U � G[ �r on the
. side',bet een F _e
at premf-ges owned by ". V
whose address is
and.to Lay House Drain, Repair House Drain, Lay--Main, Other ,
for .: , occupancy or use,,
with a'milysUnits, with;.' ages.
4 Type of'Sewsge to be•connected under this`permit:
.. SANIMY SI 1Wt1GtE ( .- j, j,NDUSTRIAL WASTES (` ), OR
Connection will be made with
F .- .f-1. Y 3•.i i - - 1 t
- -
Permii,�,to leg issued to
a- the holder of�rain•Laygr's License No. �. r•. "l er 'twill"expire on 19
ry` The undersigned.Drain Layer hf Sy,, agrees to'all t-4 'er s and c ditions set-forth o' the permit a e re gfse,slde r
thereof. Applic1.ant has received Town l?,ermir;No. az d/or G.H D Permit No. "
for'street e4cavgy�j
IAL 40DITION3
4,
i
----F °
r.
Signett
' Connec ion Charge Paid 6,00 =F' Licens'e&brain Layer ,
' Issued by
x Collector ' a
- Permit.t ee:
INSPECTION• Check-Number: _ G
INITIAL ' (Sig)
a=
FINAL (Sig) "
APPROVED (Date)
t
(Sig), °sit
INSPECTOR