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HomeMy WebLinkAboutDrain Layers Permit 20 Palmer Drive t• TOWN- OF SOUTH WI N DSOR DEPARTMENT OF POLLUTION CONTROL B/P No.: South Windsor, Connecticut List No.: S-�oS4! DRAIN LAYER'S PERMIT N? 615 J 33at 19%---- Pursuant to written applicatior, permission is hereby granted to the Licensed Drain Layer named herein to perform the work indicated below at 2© ar. ( L90 on the alYr� side, between 10."1-in ka iir Uprom Dro at premises owned bylttataa der „ .. whose address is �1! and to _ Lay House Drain, Repair House Drain, Lay Main, Other for �inl occupancy or use, with Family Units, with acres. Type of Sewage to be connected under this permit: SANITARY SEWAGE ( X), INDUSTRIAL WASTES ( ), OR Connection will be made with dLx tib imh P.M. Permit to be issued to FA a Clst► �cv the holder of Drain Layer's License No. W% Permit will expire on seats 19 74 . 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 VAN* Signed Connection Charge Paid MINA Licensed Drai ayer PWA Issued by .-mit raw Jr/ Tax Collector Permit Fee: Paid $ INSPECTION: Check Number: `::. INITIAL 3 ✓ ref ��� (Sig) FINALA.' d Ae.'' (Sig) r APPROVED 1"' (Date) y T .• ' (Sig) INSPECTOR i N � G 1 NOTES SOUTH WINDSOR POLLUTION CONTROL LOCATION ,70 OWNER rrl Z p TYPE OF WORK ( DATE 4 PERMIT PIPE f' INSTAL c'` 4r INSPECTOR DRAWN BY J'