HomeMy WebLinkAboutDrain Layers Permit 14 Pam Lane TOVI�N . OF_.� SOUTH ., WIN DSOR
'DEPARTMENT bF POLLUTION 'CONTROL
B/P No.:
South"Windsor,Connecticut
List.No.: _
DRAIN` LAYE-R'S PERMIT 963 .
16 Onto-bar 19
Pursuant to'-writien applicatior, permission is hereby granted to the'Licensed Drain Layer named herein to perform
the work b3dicated...below at pmii Lent (Let 110) o f the
side, between. .
.... at premise owned byuil X. r h
whose address ip Mail
and tq. -Lay_House Drain, .Repair House Drain, _Lay-Main, Other ,
forlLdie3. . ; ,
occupancy or+use,
with Family Units, with acres.
Type.of Se age to be connected under this permit:
SANITARY SEWAGE (2), INDUSTRIAL WASTES( ), 'OR
Connection will,be made with six-inch (6") 211111e pjj to a latorti kWOW as fttr 3#29A, at
daXLjh ak 6.6
r
Permit to be issued to _ Ades Winniwide
the holder,of Drain-Layer's License No.- W�206� Per mit•wi11 expire on 16 Docaftr 19
- The undersigned Drain Layer hereby,agrees,to all the terms and conditions set rforth 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
Signed
Connection Charge Paid 10.16.,9 i -nsed D m La
ua, " Issued by 111113C A.BdYaiidat 41ro
Tax Collector
Permit, Fee:. Paid ism
INSPECTION, Check Number: 3 $
INITIAL tote!"�'S ,/ 4tri (Sig)
FINAL a�'_ . .lr ^—^. .. (Sig)
APPROVED .10* 41trmd /97S' (Date)
TOR (Sig)
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