HomeMy WebLinkAboutDrain Layers Permit 26 Robert Drive (2) TOWN OF SOUTH WINDSOR
DEPARTMENT OF POLLUTION CONTROL
_
South Windsor, Connecticut B/P No.:
List No.: _S`�`'iv 7
DRAIN LAYER' S PERMIT iTp 801
,2 —1 19
Pursuant to written applicatior, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at T fry on the
side, between
at premises owned by ALL. + ,A
whose address is
and to Lay House Drain, Repair House Drain Lay Main, Other
for tr occupancy or use,
with (fir•) Family Units, with acres.
Type of Sewage to be connected under this permit:
SANITARY SEWAGE ( ), INDUSTRIAL WASTES ( ), OR
Connection will be made with A ;If i 1t• br 'j2C
Permit to be issued to 3`O b,w d..
the holder of Drain Layer's License No. Lt,i t 2 0 6/61ff Permit will expire on 19
The undersigned Drain Layer hereby agrees to all the t rms 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 ! Licensed n I ayeer., `-V...�.
;� {,3, M �� •'", ''
Tax Collector Issued by
Permit Fee: Paid $
INSPECTION: Check Number:
INITIAL _. �' (Sig)
w
FINAL (Sig)
APPROVED _ Y (Date)
(Sig)
INSPECTOR `