HomeMy WebLinkAboutDrain Layers Permit 416 Abbe Road TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL
B
South Windsor, Connecticut Li/P No.:
st.No.: _ 614 6_0
DRAIN LAYER'S PERMIT NO 1699
3 19 7�
Pursuant to written applicatior,'ppermission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at `7` `w /9 �j Y on the
side, between
at premises owned by�w cti r dfilli' (•�Q
whose address 's
and to Lay House Drain, Repair House Drain, La -Mai _Other Y-Main, r
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
Permit to be issued to CGS w0.r' �� t C�Q S k; OGIn��
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 t e reverse side
thereof. Applicant has received Town Permit No. and/or C H D Permit No.
for street excavation.
SPECIAL CONDITIONS to CL4-et" b e er:-Cd r".7-e /
�oy�/-,� ncL c�s� t-c)r Lester- �r'2�dpck
ec` 1
Signed +
Connection Charge Paid Q ense Drain Layer
- r
Tax CollectorT� Issued by C.et on
Permit Fee: Paid $
0 C.)
INSPECTION: Check Number: `
INITIAL (Sig)
FINAL 00, Si
APPROVED (Date)
INSPECTOR (Sig)
(1�
stir
i.
r �I
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i
NOTES SOUTH WINDSOR POLLUTION CONTROL
LOCATION (� t
OWNER
TYPE OF WORK
DATE `," ''.' " `)PERMIT ` PIPEf
INSTALLER
INSPECTOR , ` ' -. .!DRAWN BY
SCANNED