HomeMy WebLinkAboutDrain Layers Permit 41 Andmar Lane • TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL
B/P No.:
South Windsor, Connecticut Li (13/ �
st.No.: biz-�
DRAIN LAYER"S PERMIT ND 1421
�Gfnl� , 19 7�
Pursuant to written applicatior, permission is hereby granted to the Licensed Drain Layer named herein to"perform
the work indicated below at A/U"k A-441E 407 zgt-- a on the
�7 D U7rq side, between
at premises owned by u �
whose address is
and to Lay House Drain, Repair House Drain, Lay Main, Other
for h ��/�/EZA/7-1A L i
occupancy or use,
with Family Units, with acres.
Type of Sewage to be connected under this permit:
SANITARY SEWAGE 001 INDUSTRIAL WASTES ( ),,OR ( )
Connection will be made with 9!RI -Fvr_
Permit to be issued to 9!201fEN
the holder of Dram 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 1�7Q icensed Drain Layer
q z v/ Issued by
Tax Cc4lector
Permit Fee: Paid
INSPECTION: Check Number: _
INITIAL (Sig)
FINAL (Sig)
APPROVED -Z -'I (Date) SCANNED
-IRSPECTOR (Sig)
N
H�
I
BEND
NOTES SOUTH WINDSOR POLLUTION CONTROL
LOCATION LOT 29
OWNER
TYPE OF WORK
DATE PERMIT PIPE
INSTALLER
INSPECTOR DRAWN BY
INNED