HomeMy WebLinkAboutDrain Layers Permit 21 Apple Tree Lane (2) TOWN OF SOUTH WI N DSOR OB/
DEPARTMENT OF POLLUTION CONTROL o.,:
South Windsor, Connecticut �D'08G
List No.:
A
DRAIN LAYER'S PERMIT N° 562
' t , 19
Pursuant to written appli'catior, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at t 04) on the
USA side, between ftft U& paim MA '_'
at premises owned by AIM sh
whose address is
and to Lay House Drain, Repair House Drain-, Lay Main, Other ,
for occupancy or use,
with 0 ti{ Family Units, with acres.
Type of Sewage to be connected under this permit:
SANITARY SEWAGE ( ), INDUSTRIAL WASTES ( ), OR
Connection will be made with ! a
Permit to be issued to JWftArc
the holder of Drain Layer's License No. � . Permit will expire on 0 iA 1974
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
! d=n
Signed _"! `.t+ A;t•��,..� ..��_ ...
Connection Charge Paid 1,Acensed Dra n Layer
3
Issued by
Tax Collector
Permit Fee: Paid $
INSPECTION: Check Number:
- ---- - - - - --INITIAL---- - -- - - ------ --- - -(Sig)- - ---- - - ----
FINAL 1 ," i ., -�'v (Sig)
APPROVED f r':e` F (Date)
(Sig)
INSPECTOR
i
N I
NOTES SOUTH WINDSOR POLLUTION CONTROL
LOCATION 2 ► Lr. -7- C-E
OWNER L -
TYPE OF WORK
DATE s^ 3 PERMIT G G2 PIPE
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INSPECTOR r DRAWN BY