HomeMy WebLinkAboutDrain Layers Permit 07 Apple Tree Lane (2) T
TOWN OF j90-H WINDSO '
~ DEPAOTMENT OF POLLUTION CONTRO
South Windsor, Connecticut S—�j 03� G
DRAIN LAYER'S PERMIT NO 478
Oct* 19 , 19-
Pursuant to written application, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at 7 Apt* tr" Zee Lo7 �) on the
WO side, between Ar*37 Md R40UM &e
at premises owned by
whose address is son
and to _ Lay House Drain, Repair House Drain, Lay Main, Other ,
for 111 1 occupancy or use,
with S" W Family Units, with acres.
r Type of Sewage to be connected under this permit:
`SANITARY SEWAGE, INDUSTRIAL WASTES, OR
Connection will be made with Dm4u 1.MM f � a sd beetct311__maims t
Permit to be issued to
the holder of Drain Layer's License No. 18 Permit will expire on 11afte 19 l9ftu
The undersigned Drain Layer hereby agrees to all the terms and conditions set forth on the permit an the reverse A?-
thereof.. Applicant has received Town Permit No. and/or C H D Permit No. .,
for street excavation.
SPECIAL CONDITIONS D11 ISM to mat cnuh and U.-O 11 6"m a to*
Signed
Connection Charge Paid $ 10/12M Licensed Dra n Layer
ftre Be Mil S (Sig) Issued by As AWAUBMtMr Ira
Tax Collector
Permit Fee: Paid $_ 15.00
INSPECTION: *--.�
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FINAL /� �� �i _�:9v (Sig)
APPROVED (Date)
l� (Sig)
INSPECTOR
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NOTES SOUTH WINDSOR POLLUTION CONTROL
C LOCATION
/p OWNER
TYPE OF WORK
DATE PERMIT PIPE
INSPECTOR DRAWN BY