HomeMy WebLinkAboutDrain Layers Permit 06 Alison Drive TOWN OF SOUTH WINDSOR
DEPARTMENT OF POLLUTION CONTROL B/P No.:
w South Windsor,.Connectifut
List No.: _
DRAIN LAYER'S PERMIT N0 2353
,_, I9 C/
Pursuant to written applicaatior, permiss n is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at on the
side, between
at premises owned ��,ram
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 ( j, INDUSTRIAL WASTES _( ), OR ( )
Connection will be made with
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
-ay--/
1�-bq Signed
Connection Charge Paid (Jj).(/D Licensed Drain Layer
i�
Issued by
� TWCollefor
' )` Permit Fee:. Paid $
INSPECTION: Check Number:
INITIt1L (Sig)
FINAL (Sig)
APPROVED (Date)
INSPECTOR ( AN'
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NOTES SOUTH WINDSOR POLLUTION CONTROL
LOCATION
OWNER _ S �l i' i Al A-r
TYPE OF WORK ,--� _,
DATE a - PERMIT ;2-S� 3 PIPE V
INSTALLER i L L 'S
INSPECTOR C DRAWN BY C_.