HomeMy WebLinkAboutDrain Layers Permit 40 Autumn Drive TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL
B/P No.:
..yo South Windsor, Connecticut /
List.No.:
DRAIN LAYER'-S PERMIT ND 1341
19 /
Pursuant to written applizatiorf permission is l reby rdnted-to the Licen ed ;�:ayer na herein to perform
the work ind at d be at sue' �" s't iCr :' '`z ` � r on the
f iT� side between
at premises owned by
whose address is
and to _�&ay 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 W STES S ) R ( )
Connection will be made with
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 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 �
i
Connection Charge Paid 11V7 �� Licensed Drain ayer
Tax Collector Issued by
Permit Fee: Paid $
INSPECTION: Check Number:
INITIAL (Sig)
FINAL (Sig)
APPROVED 1— 7 (Date)
�a d 27 (Sig)
INSPECTOR
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S()UTH WIN:?SOP PC,!._ UTO(`N CONTROL
1PIERPAlv3V/ ]PIPE
hiNSTALLER
9. tNSfl!:i�'C�1 —y�TDPA`MNGY ��
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TOWN OF SOUTH WINDSOR !I
TOWN HALL
SOUTH WINDSOR, CONN. o6074
DEPARTMENT POLLUTION CONTROL
3
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Date . !f`. 7. . . . . . . .
f
The Sanitary Sewer . . . Septic System
or lot #. . �141 . . . . . . . . . has been installed and completed
in accordance with the Town of South Windsor ordinances
and regulations.
o a Approved
AcceK
By �`'� Date