HomeMy WebLinkAboutDrain Layers Permit 38 Andmar Lane TOWN OF SOUTH WINDSOR
DEPARTMENT OF POLLUTION CONTROL BAP No.:
South Windsor, Connecticut �� 6 List No.: _ea
DRAIN LAYER"S PERMIT NO 1419
JuaE 2 1 , 19 179
Pursuant to written applicatior, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at &DJMA/2 J.t3NA- d.eT20- .21 *1 58 on the
wc5`T side, between
at premises owned by
whose address is
and to Lay House Drain, Repair House Drain, Lay-Main, Other
for iC f��� �/�T/ `� occupancy or use,
with OAI Family Units, with acres.
Type of Sewage to be connected under this permit:
SANITARY SEWAGE (X), INDUSTRIAL WASTES .( ), OR ( )
Connection will be made with G PVC
Permit to be issued to_ 4!i,o C®N S7-.
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 Ld
Connection Charge Paid if ' ' Licensed Drain Layer
6128/ / y Issued by
Tax Collector
Permit Fee:. Paid $ ___
INSPECTION: Check Number: - A/
INITIAL (Sig)
FINAL (Sig)
APPROVED lD '2 7r (Date)
INSPECTOR (Sig)
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NOTES SOUTH WINDSOR POLLUTION CONTROL
LOCATION `-M- _z 1
OWNER
TYPE OF WORK
DATE -2 -'1 a PERMIT I y 19 PIPE 6 PVC.
INSTALLER U)vEN C o S-
INSPECTOR G Tore.k DRAWN BY