HomeMy WebLinkAboutDrain Layers Permit Pleasant Valley Road (3) ` a TOWN OF SOUTH WINDSOR
DEPARTMENT OF POLLUTION CONTROL
South Windsor, Connecticut
DRAIN LAYER'S PERMIT NO 147
WrV'►l�L�y� ��J 19
Pursuant to written application, permission is hereby granted to the Licensed Drain Layer named herein to perform
Y
the work indicated below at on the
side, between
at premises owned by
whose address is
and to Lay House Drain, Repair House Drain Lay Main, A_Other
for r-f-Si`^hti-41 occupancy or use,
with `s Family Units, with acres.
Type of Sewage to be connected under this permit:
SANITARY SEWAGE) INDUSTRIAL WASTES, OR
Connection will be made with r•;$c' i� ^�►) �= V
Permit to be issued to
the holder of Drain Layer's License No. i Permit will expire on 19 J
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 CONDITIONSa4. ',r' s' e� �`�. .+ y -'a� `G�.r, r ",
Signed
Connection Charge Paid $ Licensed Drain Layer
Tax Collector
(Sig) issued by
l
Permit Fee: Paid $ !j,ori
INSPECTION:
E°? ec% NO''
INITIAL '' (Sig)
FINAL (Sig)
APPROVED �• ,/� ._ ..v � (Date)
ry,
(Sig)
INSTEIfTORI