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HomeMy WebLinkAboutdrain layer permit 942 Sullivan Avenue TOWN OF SOUTH WI N DSOR DEPARTMENT OF POLLUTION CONTROL B/P No.: South Windsor, Connecticut ��✓�/ List.No.: DRAIN LAYER'S PERMIT NO 1550 ? CEn'IBE� 7 , 197 Pursuant to written applicatior, permission is hereby granted to the Licensed Drain Layer named herein to perform the work indicated below at Qy1--9$$ .5U4L/VAW AV6, amew Ntllm6gS on the side, between at premises owned by SDUZA MAR-rjA( 'n'dep cAI whose address is and to Lay 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: SANITARY SEWAGE ( ), INDUSTRIAL WASTES .( ), OR ( ) Connection will be made with ID V C Permit to be issued to the holder of Drain Layer's License No. Permit will expire on 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 2 Lic ad Drain Layer /Z- 7-7? Issued by Tax Collector � � Permit Fee:. Paid $ p INSPECTION: Check Number: INITIAL (Sig) FINAL (Sig) APPROVED /`L /S'7 (Date) (Sig) INSPECTOR { i t i Forz - - I s LAST'��Y SAME i AS UU TOWN fzpW)Nb ,t u Svc ly frZOm �ta�Cn,c-�vi � u 3 XV CLKlkrvOJ1