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HomeMy WebLinkAboutDrain Layers Permit 22 Schweir Road TOWN OF SI '.mi WI N DSOR DEPARTMENT OF POLLU;ION CONTROL B/P No.: South Windsor, Connecticut � .�'�s' List No.:,,�-_"' —:L? _V DRAIN LAYER' S PERMIT N? 516 Tom. 10 , 19 73 Pursuant to written applicatior, permission is hereby granted to the Licensed Drain Layer named herein to perform the work indicated below at Lot ;* Scliweir iit°. on the reent side, between_ Stt_,_?iyan Ave. & Cul—chase at premises owned by- THyii(dore R. «+2"ubay whose address is Lot it 3 and to Lay House Drain, Repair House Drain, Lay Main, Other ComOrcfitX , for Cd �•'�`y- •! K.duatrial occupancy or use, with Cxe Family Units, with acres. Type of Sewage to be connected under this permit: SANITARY SEWAGE (X ), INDUSTRIAL WASTES ( ), OR ( ) Connection will be made with six (0) iac;h Permit to be issued to ACIAM WiF6!ij ewWWi. the holder of Drain Layer's License No.W9*206559 Permit will expire on Fob, 10 191_ 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 street excavation. SPECIAL CONDITIONS ora-'A la tl r tc p"E'• cr1ds" aud baO iAIL aept4 u, uwis s Signed j Connection Charge Paid ii'f ijhl_sLicensed Drain Layer ,-,*ro ,!:. IiC3Aiz Issued by RrIplt h• it;.?4: ' ':2X' 4r. Tax Collector Permit Fee: Paid $ _`—',' _ INSPECTION: Check Number: INITIAL r ' " /© (Sig) FINAL T� � ,rt--? ry G. cr (Sig) APPROVED fr (Date) s �. _ (Sig) INSPECTOR N a� s 01 I�- �q NOTES SOUTH WINDSOR POLLUTION CONTROL LOCATION - OWNER 74� lE TYPE OF WORK DATE ,r PERMIT - PIPE 4 v, INSTALLER lga,,glv7 INSPECTOR gEC DRAWN BY .S'