HomeMy WebLinkAboutDrain Layers Permit 1105 Strong Road TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL
South Windsor, Connecticut B/P No.:
List No.:
DRAIN LAYER'S PERMIT
N° 1588
- -4�Ta,. Z 7 , 19-7J—
Pursuant to written applicatior, permission is hereby ranted to the Licensed Drain Layer named herein to perform
the work indicated below at ,
- on the
side, between
at premises owned by
whose address is r0
and to La House Drain, Re air House Drain, La Mi
Yan Other
for ,
occupancy or use,
with 1� Family Units, with
acres.
Type of Sewage to be connected under this permit:
SANITARY SEWAGE (U�, INDUSTRIAL�WASTES ( ), OR ( )
Connection will be made with r„ �� /,� � 04G
Permit to be issued to
the holder of Drain Layer's License No._Z O 9 2� Permit will expire on
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 Licensed D in Layer
-7 9
Tax Collector / / Z Issued by
4:2= "Z
Permit Fee: Paid $
INSPECTION: Check Number: /7
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
INSPECTOR (Sig)