HomeMy WebLinkAboutDrain Layers Permit 115 Pine Knob Drive TOWN OF SOUTH WI N DSOR ., .
`DEPARTMENT ,0F POLLUTION CONTROL,"'
B/P No.:
South Windsor, Connecticut
List No.: {e>d;`le�3
DRAIN; LAYER'S .PERMIT , K? 727
vrnm6w 19 74
Pursuant to writt$n applicatior, permission is hereby granted'to the Licensed Drain Layer named herein to perform
the work indicated.below ai 'It z ! 'a *"`ii at) on the
side, between_ , ti[r
at premises owned by
whose address is
and to Lay House Drain,'_Repair House Drain, Lay-Main, Other ,
for occupancy or use,
with ' Family Units, with acres.
Type of Sewage to be connected under this permit:
SANITARY SEWAGE ), INDUSTRIAL WASTES .( ) OR ( )
Connection_ will be m de with summa visa ID it U at jaug ak lk
Permit to be issued to y
the holder,of Drain Layer's Lit:ense No._' Permit will expire on 1101we 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
Signed F .,
Connection Charge Paid Licensed Drain Layer
Issued`-by
Tag Collector
Permit Fee:. Paid
INSPECTION: Check Number: ,
_.
INITIAL (Sig) _
(Sig)
APPROVED (Date)
y
g emu,
Y- - ,
,� INSPECTOR (Sig)
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