HomeMy WebLinkAboutDrain Layers Permit 205 Tumblebrook Driv TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL
B/P No.:
South Windsor, Connecticut
List.No.: _
DRAIN LAYER'S PERMIT NO 1570
btA 10 , 191�
Pursuant to written applicatior, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at LAiA b �� bS`D t� �C on the
side, between
at premises owned by u
whose address is
and to _)LLay 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:
--- -
SAKIT-ARY SEWAGE (w, INDUSTRIAL WASTES .( ),-OR
Connection will be made with - (� 1� �q
Permit to be issued to
the holder of Drain Layer's License No. Permit will expire ony 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 N'o.
for street excavation.
SPECIAL CONDITIONS
Signea AM
Connection Charge Paid' License rain Layer.`
'/-.' '.r Issued by
Tax Collector
Permit Fee: Paid $
INSPECTION: Check Number: iq
INITIAL (Sig)
FINAL (Sig)
APPROVED I / ' 17 (Date)
(Sig)
INSPECTOR
A: � -j„
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