HomeMy WebLinkAboutDrain Layers Permit 10 Andmar Lane TOWN OF SOUTH WI N DSOR ~
DEPARTMENT OF POLLUTION CONTROL
South Windsor, Connecticut B/P No.:
List No.: --
DRAIN LAYER'S PERMIT N? 1417
•�LJAI E 2 2 , 19
Pursuant to written applicatior, permission is hereby granted to the Licensed Drain Layer named herein to perform
the-work indicated below at_,_ A" /y11�f2 � OT
on the
side, between
at premises owned
whose address is
and to Lay House Drain, ..Repair House Drain, Lay-Main, Other
for gg&R
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_- �d V 'wi 01 OIV S77911 Al
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 �`i0� Licensed Drain Layer
6 2 7 1 Issued by
Tax Co lector
Permit Fee: Paid $
INSPECTION: Check Number:
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)---A& CANS ' ,
S
�40k4 (Sig)
INSPECTOR
N
MAN40L
! C.ATC t?
J
i
NOTES SOUTH WINDSOR POLLUTION CONTROL
LOCATION a
OWNER
TYPE OF WORK
DATE 6-22-T3 PERMIT tq ► PIPE
INSTALLER Cr r1 w !V s T
INSPECTOR DRAWN BY
.