HomeMy WebLinkAboutDrain Layers Permit 190 Orchard Hill Dri } TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL
South Windsor, Connecticut B/P No.:
List No.: _-
DRAIN LAYER'S PERMIT N? 768
19
Pursuant to written applicatior, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at on the
side, between
at premises owned by
whose address is
and to Lay House Drain, Repair House Drain, Lay Main, Other
for occupancy or use,
with (.-r- Family Units, with acres.
Type of Sewage to be connected under this permit:
SANITARY SEWAGE (•- ), INDUSTRIAL WASTES ( ), OR ( )
Connection will be made with
Permit to be issued to
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 permit and the reverse side
thereof. Applicant has received Town Permit No. and/or C H D Permit No.
for street excavation.
SPECIAL CONDITIONS
Signea
Connection Charge Paid it- IS- -74 Licensed Drain Layer
JC "G` ►�a, Ce(o J Issued by
Tax Collector
Permit Fee: Paid $
INSPECTION: Check Number:
INITIAL (Sig)
FINAL (Sig)
APPROVED t Z- 20- '74 (Date)
FJ s (Sig)
INSPECTOR
r
R
N
a,
of oy-
NOTES SOUTH WINDSOR POLLUTION CONTROL
LOCATION
OWNER
TYPE OF WORK
DATE PERMIT PIPE
INSTALUX
INSPECTOR DRAWN BY