HomeMy WebLinkAboutDrain Layers Permit 18 Andmar Lane TOWN OF SOUTH WINDSOR
DEPARTMENT OF POLLUTION CONTROL
B/P No.:
�{ South Windsor, Connecticut to List No.:
DRAIN LAYER'S PERMIT Np 1420
Jun/E 2,3 19 _.
Pursuant to written applicatior, permission is hereby granted to the Licensed Drain Layer named herein to perform
'
the work indicated below at 1 I
/7/V.P-A4 07' -2- on the
wCiF5'-r side, between
at premises owned by
whose address is
and to Lay House Drain, Repair House Drain, Lay-Main, Other
for Af 4i ll/ rJAJ— occupancy or use,
with �/�� Family Units, with acres.
Type of Sewage to be connected under this permit:
SANITARY SEWAGE (x), INDUSTRIAL WASTES ( ), OR ( )
Connection will be made with
Permit to be issued to e OVE/V 10/VST7,
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
Connection Charge Paid Je a®%i Licensed Drain Layer
w 1z a I Issued by
Tax ollector
Permit Fee:. Paid $
INSPECTION: Check Number: .
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
(Sig)
ECTOR
SCANNE
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NOTES SOUTH WINDSOR POLLUTION CONTROL
LOCATION LQ± 32
OWNER
TYPE OF WORK
DATE PERMIT PIPE
INSTALLER
INSPECTOR DRAWN BY
SCANNFr