HomeMy WebLinkAboutDrain Layers Permit 7 Ravine Road t �
TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL
South Windsor, Connecticut B/P No.:
List No.: �
DRAIN LAYER'S PERMIT
Tp 7
80
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Pursuant to written applicatior, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at on the
ggGukh side, } t,�t•� '� (• 1R�]C ti.+ Ai]f14,h 612d f J-
2sls�i5�1 ., k.CLf,
at premises owned by PAt- j, ;_ Ti iiig'iir �Qrj y
whose address is aoas
and to I Lay House Drain, Repair House Drain, Lay Main, Other
for raalda&t_i-a.l occupancy or use,
with a&a1 Family Units, with acres.
Type of Sewage to be connected under this permit:
SANITARY SEWAGE (X ), INDUSTRIAL WASTES ( ), OR ( )
Connection will be made wither xmixrh (Qf) Nlagtj; t
Permit to be issued to&lal 1 Zdai r INC-
the holder of Drain Layer's License No. W4.;Xl61 A Permit will expire on / 4� eh 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 f3"I� +`�J .l Licensed Drain Lay6r �{�`� —
ldataYkt No_ 71Od Issued by
Tax Collector
Permit Fee: Paid $
INSPECTION: Check Number:
40
INITIAL r A (Sig)
FINAL (Sig)
APPROVED_ (Date)
�� ,t ,� (Sig)
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