HomeMy WebLinkAboutDrain Layers Permit 44 Andmar Lane TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL B/P No.:
South Windsor, Connecticut
List.No.:
DRAIN LAYER'S PERMIT N? 1585
1 tr,4. ,6 , 19_
Pursuant to written applicatior, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at on the
e
side, between
at premises owned by
whose addre 01
and to Lay House Drain; Repair House Drain, Lay-Main, Other
for occupancy or use,
with q—Family Units, with acres.
Type of Sewage to be connected under this permit: zi��
SANITARY SEWAGE ( ), INDUSTRIALL/ WASTES
�( /), OR
Connection will be made with (� tf /" �/
e-�
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
a Signe i e C
Connection Charge Paid 7 Licensed rain Layer
- J J Q� Issued by
Tax Collector
Permit Fee:. Paid $ _�5— �i
INSPECTION: Check Number: 4-7 0 ee _�"�
INITIAL (Sig)
FINAL (Sig)
APPROVED Z (Date)
(Sig)
INSPECTOR ^ /�
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N � �
tFr\
R \
Z
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NOTES SOUTH WINDSOR POLLUTION CONTROL
LOCATION o T
OWNER
TYPE OF WORK 5A.1/, e-
DATE-3 PERMIT 5 PIPE 6
INSTA LE
INSPECTORA N BY
SCANNED