HomeMy WebLinkAboutDrain Layers Permit 350 Pleasant Valley (2) TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL
South Windsor, Connecticut
DRAIN LAYER'S PERMIT 'O 37
a " l , 19
Pursuant to written application, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at .a . jilakbtt gig jv ik&h s I on the
r. .il side,., !'* $ s +C4 : itaHe!'
at premises owned byram. .4. 418040,444
whose address is P [�-A!j,,*y A& �S
and to Lay House Drain, Repair House Drain, Lay Main, Other ,
forihir�# fills r occupancy or use,
with Family Units, with „ ` acres.
Type of Sewage to be connected under this permit:
INDUSTRIAL WASTES, OR
Connection will be made with * Ir des
Permit to be issued to A A. %Tt wl
the holder of Drain Layer's License No. J tjtg' Permit will expire on r 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.0 H D Permit No.
for street excavation.
SPECIAL CONDITIONS'—' .
Signed
Connection Charge Paid $& fad Licensed Drain Layer
Sa1F _A*!t At 0 (Sig) Issued by
Tax Collector
Permit Fee: Paid $ #
INSPECTION: #Nj'#jk
INITIAL (Sig)
FINAL (Sig)
APPROVED ; , erjt& (Date)
f` r At"t wit (Sig)
INSPECTOR