HomeMy WebLinkAboutDrain Layers Permit 34 Wentworth Drive TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL B/P No.:
South Windsor, Connecticut f
List.No.: fS 8
DRAIN LAYER'S PERMIT N? 1619
, 19
Pursuant to written applicatior, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at 3.V64t A4 u,h,a 't fif• fit/��✓�lit/O/L7%)� ` �/ �e��E -Itt_ 3 4-- on the
side, between
at premises owned by n j -T,
whose ad�dree is ;2 jL9.41) 6!� f�,�', ./�i4��{�� 2 0 ��33
and to Lay House Drain, Repair House Drain, Lay Main, Other ,
for /J occupancy or use,
1
with Family Units, with acres.
Type of Sewage to be connected under this permit:_
SANITARY SEWAGE (INDUSTRIAL WASTES ( ), OR ( )
Connection will be made with �vc�
!�
Permit to be issued to ""�� p
the holder of Drain Layer's License No. GwC118� / Permit will expire on �� �D/�7/� 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
Signed
Connection Charge Paid rr Licensed Drain Layer
Ce h P (Zi 1 Z 7 `� 4 �i Issued by
Tax Collector
Permit Fee:. Paid $
INSPECTION: Check Number.:
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
(Sig)
INSPECTOR