HomeMy WebLinkAboutDrain Layers Permit 73 Sycamore Road " TOWN OF SOUTH WINDSOR
DEPARTMENT OF POLLUTION CONTROL g(p No.:
South Wmd.a., Cxnneaear et No.:
DRAIN LAYER'S PERMIT N4 1467
z& riu/<T Z. , 19,��
no,eoanom written applic t , pee s heathy retired mohe Licensed Omm Lou,, named M1erem w perform
the walk indicated below at 73 i6iotcAmAgr 99 L T 2. 3a on ;he
aide, between
atD Data... awned by C
whose address is
and in f0 _Lay horde Dole, _Repnie Haute Drum, _Lay Slain, _OtMe
foe eoparty or neq
with Atigor Family Units, wish
Type of Sewage to be connected nad,, this per
SAEUTARY SEWAGE (X), INDUSTRIAL WASTES (�), OR ( )
Connection will be made with
Permit to be forced to SAC 8 CCZ ' C s-r
the holder of Tom, Layei a License No. . Permit
e will'e,T n 19_
The oadees!good pee Layer hereby agrees mall the term, tad conditi et watch on the�heaid,
thereof. AppU,,m he, received Town Permit No. - ,nd/o, C H D Permit No.
foe suet ez n.
SPECIAL CONDITIONS
Signed �P /F tvO
Connector, Charge Paid IZZI e� L/e d 01111
Loyee
r- 1- I�I A farmed by F� Aedel
Tax Collector
permit pee: tea 4 �6/
INSPECTION: Check Number:
LYrcuL (Sig)
FINAL (Sig)
APPROVED ////P'3- 76 (Dote)
Y� /.lU // (Sig)
SP CTO
1
N
�Y
6�
�a+emi
NOTES SOUTH WINDSOR POLLUTION CONTROL
OCATION ', - t5R Svc c Rd
OWNER LoCo.
TYPE OF WOW ca Connec+lmn
OATS 6-z-Y6 PEEPIT i464 PIPE " R ✓.c.
INSTALLER
INSPECTOR .' DRAWN BY C. K.