HomeMy WebLinkAboutDrain Layers Permit 63 Robert Drive (3) TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL B/P No..
South Windsor, Connecticut
List.No.. _
DRAIN LAYER'S PERMIT -
N° 12'79
� 19
Pursuant to written applicat}or, permission is,hereby/graneq to the Licensed Drain Layer named herein to perform
the work in t cated l elow at t-�. /,� r �. // +;s on the
side, betwekn
at premises owned by`c A;: f
C'
whose address is
and to 7Z—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 .
( xha 4 )
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 sweet excavation. ����
SPECIAL CONDITIONS lvo
Signed >
Connection Charge Paid �� sed Drai ayer
Issued by
Tax Collector
Permit Fee: Paid $
INSPECTION• Check Number:
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
INSPECTOR (Sig) r
41'77- �