HomeMy WebLinkAboutDrain Layers Permit Lot 3, Pleasant Vall TOWN SOUTH WINDSOR
DEPARTMENT OF,,POLLUTION CONTROL
South Windsor, Connecticut
DRAIN LAYER'S PERMIT `O 7919
Pursuant to;,written application, permission is hereby gr
��a
jjnted to the Licensed Drain Layer named herein to perform
the work indicated';below alar,3. 4G.,44 ,yr 14444fy /�oA4 bon the
�etrN side, between;'' ; ; _ s ,r > Utz
at premises owned i- ,q OffA.
whose address is
f p
and to Lay House Drain, Repair House Drain, Lay Main, Other
4
for occupancy or use,
with tc r.' a 1 Family Units, with acres.
Type of Sewage to be connected under this permit:
ANITARY SEWAGE" INDUSTRIAL WASTES, OR
Connection will be made with 4~ .'. `_ >C i,
r: Perm'16to be issued to
the holder of Drai ,La er's License a
.. y Permit'will expire on P #" �::. _*- 19 .
` The:undersigned Dra,ln.Layer hereby agrees to all the terms and conditions set forth on the permit'and the reverse side
thereof, A 'plicant=haq.received Town Permit No. and/or C H D Permit No.
for street excavat10;1- a ,;
SPECIAL CONDITIONS
t
Signed
Connection Charge Paid $ ,' - a
�t �' icen d D
(Sig) Issued by d"w.,k #
Tax Cgilector
Permit Fee: Paid $
INSPECTION: CNd 44% 110 ,
INITIAL (Sig)
FINAL ts,. � s (Sig)
APPROVED (Date)
SPEC OR (Sig)