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HomeMy WebLinkAboutDrain Layers Permit 264 Skyline Drive `TOWN OF SOUTH WI N DSOR DEPARTMENT OF POLLUTION CONTROL B/P No.: South Windsor, Connecticut List.No.: _ DRAIN LAYER' S PERMIT N? 906 Pursuant to written applicatior, permission is hereby granted to the Licensed Drain Layer named herein to perform the work indicated below at %0t--62 1486ft " SK-1 Li j on the side, between at premises owned by whose address is and to _ Lay House Drain, Repair House Drain, Lay Main, Other for 11 —#11&1 occupancy or use, with (tea Family Units, with acres. Type of Sewage to be connected under this permit: SANITARY SEWAGE (x ), INDUSTRIAL WASTES ( ), OR Connection will be made with_ 84 X Tuab nagtf a M Permit to be issued to ld Taaabacai r the holder of Drain Layer's License No.Y-9 Permit will expire on Ob estalbW 19 A_ 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 Signed � �x) Connection Charge Paid zmmLicensed Drain Layer IM30 Issued by N• ftMft Frirtd Tax Collector Permit Fee: Paid $ 2-7 INSPECTION: Check Number: INITIAL QZirl J ,Jle) (Sig) FINAL 69 11/ (Sig) APPROVED A? C-1 /97-v, (Date) 7A (Sig) �° INS C OR