HomeMy WebLinkAboutDrain Layers Permit 411 Abbe Road TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL
South Windsor, Connecticut B/P No.:
List.No.: _
DRAIN LAYER'S PERMIT N? 1692
19—L
Pursuant to written applicatior, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at on the
side, between
at premises owned Ica N--c1
whose address is
and to Lay House Drain, Repair House Drain, Lay Main, Other
for
occupancy or use,
with Family Units, with acres.
Type of Sewage to be connected under this permit:
SANITARY SEWAGE ( ), INDUSTRIAL WASTES ( ), OR ( )
Connection will be made with G
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 per and the reverse side
thereof. Applicant has received Town Permit No. and/or C H D Permit No.
for street excavation.
SPECIAL CONDITIONS
Co Signed
I
Connection Ch�arg�e�Paid (� 2 Issued by Licensed Drain Layer
`� °
Tax Collector
Permit Fee: Paid $
INSPECTION: Check Number:
INITIAL (Sig)
FINAL ` (Sig
APPROVED (Da$CANNED
(Sig)
INSPECTOR
f
i
a o �
l
17,
i
G �
�Ae
1
NOTES
SOUTH WINDSOR POLLUTION CONTROL
LOCATION
OWNER *o C
\/ TYPE OF WORK o ., C -s rdr t
DATE / 2 PERMIT 6 PIPE
C' INSTALlYR C c, c
INSPECTOR DRAWN BY 77,
C(,(
� ,� � SCANNED