HomeMy WebLinkAboutSeptic Repair 150 Felt Road a TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL gip No.:
South Windsor, Connecticut S G 10-3 s
List.No.: _
DRAIN LAYER'S PERMIT No 1100
�uri;-, 19
Pursuant to written applicatior, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at 1`>0 i'<::; t 7'--aa on the
., side, between 0 kljui1 MO.!.erati
at premises owned by
whose address is s;r
and to X 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 ai z--in; 'i i 6)"
Permit to be issued to
the holder of Drain Layer's License No. 1i` ';f, f`i`? Permit will expire on (j'> ,,;; 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 I !
Connection Charge Paid ci Licensed Drain Layer
Issued by r,<
Tax^Collector
Permit Fee: Paid $ __'` L-_r,
INSPECTION: Check Number: ,
INITIAL (Sig)
FINAL (Sig)
APPROVED 0 .g o','c (Date)
(Sig)
INSPECTOR