HomeMy WebLinkAboutDrain Layers Permit 872 Pleasant Valley TOWN OF SOUTH WINDSOR
DEPARTMENT OF POLLUTION CONTROL B/P No.:
South Windsor, Connecticut
List No.: _
DRAIN LAYER'S PERMIT NO 1553
/A , 19 -7,'
Pursuant to written applicatior, permission is hereby granted to the Licensed Drain Layer named herein to perform
t/ . / n
the work indicated below at 7}��I�PL��I 'q-/�rr� 1/13GL Do C� Z on the
side, between
at premises owned by ' �IYI i I L 1!I I F
whose address is
and to _Lay House Drain, Repair House Drain, Lay-Main, Other
for kes is q zy:z.4gv— 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 made with ,/®I��
Permit to be issued to— C&4 I(E/V C,G A T ,
the holder of Drain Layer's License No. Permit will expire on 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
Connection Charge Paid n124 Licensed Drain Layer
Issued by
Tax Collector
Permit Fee: Paid $
INSPECTION: Check Number:
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
INSPECTOR (Sig)
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