HomeMy WebLinkAboutDrain Layers Permit 59 Steep Road TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL gip No.:
South Windsor, Connecticut /
List No.:
DRAIN LAYER'S PERMIT M 2282
fe6 , 19��
Pursuant to written applicatior, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at on the
side, between
at premises owned by -,Wn 6- 116411
whose address is
and to 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 WASTES .( ), OR
Connection will be made with
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 street excavation.
SPECIAL CONDITIONS
W Signed
Connection Charge Paid Lop p License Drain Layer
Issued by
Tax Collecto
Permit Fee: Paid $ _�-
INSPECTION: Check Number:
INITIAL (Sig)
FINAL (Sig)
APPROVED J / (Date)
h
(Sig)
INS ECTOR
N
NOTES SOUTH WINDSOR POLLUTION CONrRQL
LOCATION
OWNER 0 �' ►� o► M a... rR �,
TYPE OF WORK a„ ; . r
DATE - PERMIT 62p. DIPF
INSTALLER a_c_ c e_
INSPECTOR DRAWN BY