HomeMy WebLinkAboutDrain Layers Permit 15 Pine Tree Lane TOWN OF SQVT
tj Wl.N.DSOR
7, 't DEPARTMENT OF POLLUTION CONTROL
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South Windsor, Connecticut
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! DRAIN LAYER'S PERMIT 334
Pursuant to written application, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at 45 1PN r aroo L.-ag (Lot 74) on the
it
rS14t side, between ado al-('.t.l: DY"irc wyr3 1k,17e
at premises owned by Pay'- $'. Lr alive
whose address is Cr1r,10
and to ez Lay House Drain, Repair House Drain, Lay Main, Other
for roC clerti '! occupancy or use,
with o r r I.!i Family Units, with acres.
Type of Sewage to be connected under this permit:
± SANITARY SEWAGE, INDUSTRIAL WASTES, OR
Connection will be made with pler'tj
a nib
Permit to be issued to Jctx-, A. LEtY. mn
the holder of Drain Layer's License No. 4 9-024,1V-j . Permit will expire on 1,9 Septagjbor 19 ' ?,.
The undersigned Drain Layer hereby agrees to all the terms and conditions set forth on the permit and the reverse side
thereof. Applicant has received Town Permit No. and/or C H D Permit No.
for street excavation.
SPECIAL CONDITIONS_ a-.aim Layer to 1:+sp,, crux i, paid
Signed
♦ .R
Connection Charge Paid,'$ Licensed Draili Layer
'..J or
(Sig) Issued by
Tax Collector
Permit Fee: Paid $' ?;
INSPECTION:
INITIAL (Sig)
FINAL (Sig)
APPROVED %3 J Lk 19,73 (Date)
1441. ILL.L. (Sig)
INSPECTOR
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NOTES SOUTH WINDSOR POLLUTION CONTROL
LOCATION Cr•,.,F ( L 1�
OWNER
TYPE OF WORKF.
DATE PERMIT 334 PIPE,,,,"
INSTALLER
INSPECTOR DRAWN BY --