HomeMy WebLinkAboutDrain Layers Permit 179 Robert Drive (2) TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL gip No.:
South Windsor, Connecticut
List.No..
DRAIN LAYER'S PERMITtp 773
19
Pursuant to written application, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at 11 on the
side, between
at premises owned by - ry V-'i 'a-
whose address is im*
and to t 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 WASTE
S:'( ), OR •(
Connection will be made with 'SIX MV-h PAIWUX
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-�s�av�t'fon:
SPECIAL CONDITIONS
Signed f .
Connection Charge Paid E ., Licensed Drain Layer
Issued by -fthfk 4 O.
Tax.Collector -
Permit Fee:. Paid $
INSPECTION: Check Number:
INITIAL (Sig)
Was
FINAL (Sig)
Kris
APPROVED (Date)
(Sig)
INSPECTOR