HomeMy WebLinkAboutDrain Layers Permit 151 Robert Drive TOWN OF SOUTH WI N DSOR
p DEPARTMENT OF POLLUTION CONTROL , k
South Windsor, Connecticut
List No.: _
DRAIN LAYER'S PERMITt ? 8'1`
28 Jas»+fir ,19-25_
Pursuant to written applicatior, permission is hereby granted to.the.Licensed Drain Layer named herein to perform
the work indicated below at _#Var Rn*%pri• on the
eaXt side, 1$ _ ra&j g& +i+hA.=6 3E'i0
at premises owned by :2,AVQ + E, Spla"
whose address is
and to _I Lay House Drain, Repair House Drain, Lay Main, Other
for danfit occupancy or use,
with one (1) Family Units, with acres.
Type of Sewage to be connected under this permit:
SANITARY SEWAGE (37), INDUSTRIAL WASTES ( ), OR ( )
Connection will be made wit rr
dolt of 7,09we
Permit to be issued to __ Alan 1_IMiewaki
the holder of Drain Layer's License No. W036,706959 Permit will expire on_2, March 19�_
The undersigned Drain Layer hereby agrees to all the terms and conditigns 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
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Connection Charge Paid 01— Signed i�ensed rh'fri' a�q ram^—
R0I013 t Ko• 712 Issued by F� k ]'� ►tllil.�
Tax Collector
Permit Fee: Paid $
INSPECTION: Check Number:
INITIAL (Sig)
FINAL _1 __ to ' (Sig)
APPROVED (Date)
t 4R, rI *r (Sig)
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