HomeMy WebLinkAboutDrain Layers Permit 63 Robert Drive (2) TOWN OF SOUTH WINDSOR
DEPARTMENT OF POLLUTION CONTROL gip No.:
South Windsor, Connecticut
List No.: _
DRAIN LAYER'S PERMIT -
N° 1279
j 19
Pursuant to written applicattor, permission is,hereby]gragtc�to the Licensed Drain Layer named herein to perform
r
the work in ,'cated §elow at C < [./9-Y 11, t7 � , (` on the
side, betty n
at premises owned by
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 ( , INDUSTRIAL WA$'t'ES .
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
01
Signed
Connection Charge Paid �� sed Drai ayer
// ,7/ w Issued by
Tax Collector
Permit Fee: Paid _ 4
INSPECTION: Check Number: ,
INITIAL (Sig) .�--
FINAL (Sig)
APPROVED (Date)
(gig)
r1'77—
INSPECTOR4
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