HomeMy WebLinkAboutDrain Layers Permit 143 Robert Drive • `'- TOWN OF SOUTH WIND '
DEPARTMENT OF POLLUTION CONTROL
B/P No.:
South Windsor, Connecticut
List.No.:
DRAIN LAYER'S,PERMITp 937
19
Pursuant to written applicatior; permission is hereby granted.to the Licensed Drain Layer named herein to"perform
the work indicated below at j"&rt11! on the
side, between
at.premises owned by �++•rr3_ Wi ankn
whose address is an*
and.to LXTLay House Drain, - Repair House Drain, Lay-Main, Other
for occupancy or use,
with Une Family Units, with acres.
Type of Sewage to be connected under this permit t
SANITARY SEWAGE {Y j, INDUSTRIAL WASTES "( ), `OR
Connection will be made with �4�c „eh 3at !_Es pftl!
Permit to be issued,to
the holder of Drain Layer's License No. 9 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.
G%Ca_Qatio'n -:. .. _ _.- z_.-:_ -
SPECIAL CONDITIONS
i
Signed
Connection Charge Paid 8M Lice�nsedrain Layer
Issued by . SWItA
Tax Collector
Permit Fee:. Paid $ 1 !
INSPECTION: Check Number:
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
(Sig)
INSPECTOR