HomeMy WebLinkAboutDrain Layers Permit 90 Robert Drive TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL
B/P No.:
South Windsor, Connecticut �^ J
List No.: _
DRAIN LAYER'S PERMIT NO 1339
19
Pursuant to written applicatior, permissi is hereby granted to—the Licensed Drain Layer named herein to perform
the work indicated below at `. on the
' - side, between '
at premises owned by e,0 4 47,2 Q
whose address is
4
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 (>p, INDUSTRIAL W kSTES
r�
Connection will be made with
Permit to be issued to
the holder of Drain Layer's License No. Permit will expire on 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 O Licensed Drai er
Issued by
Tax Collector
Permit Fee:. Paid $ _ /w!0 0
INSPECTION: Check Number:
INITIAL (Sig)
FINAL (Sig)
APPROVED -f (Date)
(Sig)
INSPECTOR
-( N
J
+ �� Z•
Ty /
/7' ��L3'
# 90
beta
a (�A
1
J
�U►� Ud tN:?;CDR P�a_t_U� IC N Ct-)NT ROL
liO(ATiON Q /yid
I Y `� .Ot �4Ok i U
AAt
k
l�
/E
r
ti.
4
r I