HomeMy WebLinkAboutDrain Layers Permit 63 Pleasant Valley R TOWN OF SOUTH WINDSOR
DEPARTMENT OF,6PQ,LWTION CONTROL
/U ( South Windsor, Connecticut
DRAIN LAYER'S PERMIT N? 474
out 1$ , 19 73
Pursuant to written application, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at ELftMO't TiMW FA, on the
MOUft side, between_ !! iRt_
at premises owned by
whose address is 4 !
and to x Lay House Drain, Repair House Drain, Lay Main, Other
for nAd tW occupancy or use,
with Atlw Family Units, with acres.
Type of Sewage to be connected under this permit:
SANITARY SEWAGE, INDUSTRIAL WASTES, OR
Connection will be made with d7[ 1W* (6)
Permit to be issued to AMMt
the holder of Drain Layer's License-No. 1 Permit will expire on "„ �g 1
The undersigned Drain Layer hereby agrees to all the.terms and conditions set forth on the permit and the reverse si e
thereof. Applicant has received Town Permit No. and/or C H D Permit No.
for street excavation.
SPECIAL CONDITIONS
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1aj18 Signed
Connection Charge Paid $ Licensed Drain Layer
P*ro E. NMIA (Sig) Issued by >i;dph d+ dt -Tkyftth*r Jr*
Tax Collector
Permit Fee: Paid $t-'()D
INSPECTION:
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
:(Sig)
INSPECTOR
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NOTES SOUTH WINDSOR POLLUTION CONTROL
LOCATION ? ,-'.7 :7-7,777 '/,�? 7 77 t 7,71
OWNER
TYPE OF WORK fT- 2,1=-
DATE = % ERMTT PIPE
INSTALLER = S /,.sic'
INSPECTOR DRAWN BY