HomeMy WebLinkAboutDrain Layers Permit 161 Skyline Drive TOWN OF SOUTH WINDSOR t
DEPARTMENT OF POLLUTION CONTROL
B/P No.:
South Windsor, Connecticut r 7 7
List No.: _
DRAIN LAYER'S PERMIT N? 928
Pursuant to written application, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at on the
east side, between
at premises owned by
whose address is
and to Lay House Drain, Repair House Drain, Lay Main, Other
for
occupancy or use,
with on Family Units, with acres.
Type of Sewage to be connected under this permit:
SANITARY SEWAGE ( X), INDUSTRIAL WASTES ( ), OR ( )
Connection will be made with Qi.;.. iricli 1 a:a:'c 12i-Y)e
Permit to be issued to Rontrld Iaco ucci
the holder of Drain Layer's License No. W0J- Permit will expire on 04 October 19 79
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
Connection Charge Paid oo/02/? Licensed Drain Layer
//y+"4 4 Issued by � 'i_, , >;, _-; l"-ri end
Tax Collector
Permit Fee: Paid $
INSPECTION: Check Number: `+
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
(Sig)
INSPECTOR