HomeMy WebLinkAboutDrain Layers Permit 41 Riverside Drive 4.
TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL Bhp No.:
South Windsor, Connecticut
- List.No.: _
DRAIN LAYER"S PERMIT N? 3559
141 PUU. U� QA- ao2b , 19db—
Pursuant to written applicatior, permiTt
s hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at �T C� e,,L on the
side, between
at premises owned by r\/6t
whose address is
and to Lay House Drain, Repair House Drain, Lay-Main, Other ,
for occupancy or use,
with Family Units, with acres.
Type of Sewage to be connected under this permit:
SANITARY SEWAGE ( j, INDUSTRIAL WASTES .( ), OR ( )
Connection will be made with
Permit to be issued to
the holder of Drain Layer's License No. 1 Permit will expire on 19
"'"',-The undersigned Drain Layer hereby agrees to all the to s 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-s-tieet-eetwvatrr.- -_-
SPECIAL CONDITIONS
Signed
Connection Charge Paid Licensed Drain Layer
Issued b Tax Collector e
Permit :Fee: Paid $
INSPECTION• Check Number: 595
INITIAL (Sig)
FINAL (Sig)
APPROVED Z? `c/� (Date)
' (Sig)
INSPECTOR