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HomeMy WebLinkAboutDrain Layers Permit 05 Autumn Drive (3) r TOWN OF SOUTH WINDSOR DEPARTMENT OF POLLUTION CONTROL B/P No.: South Windsor, Connecticut List.No.: _ DRAIN LAYER'S PERMIT NO i368 �2- z9 119 .77 Pursuant to written applic ior, rmission is hh /��y, gr ted to the Licensed Drain Layer named herein to perform the work indicated below at J0 ` 4or I2 ©�. . on the side, between at premises owned by 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 ASTES ) 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 y Connection Charge Paid , 1:icense aln Layer Issued by Tax Collector 4� Permit Fee:. Paid $ INSPECTION: Check Number: INITIAL (Sig) FINAL (Sig) APPROVED (Date) (Sig) INSPECTOR 1 ,i � _ _. "�. _ �,. ,, f F' i�-,�lf - --- � � _._ _ - - \_- ---. __- - _..__ J11_.- -_ - _, .._ /�� f .. �\ j ._ .�_. f r _ �( ._. _. :. '1. _ _ _ � ._._ ... _. _ �.` ` _ V _._. - 1 1 __ i t +' � f. ; � � � ,� I �� �I r 1 y r l t �� r� ��-. _. __ - --.- l. ` _ © ✓ f n / v 0 n/11 3' �OCATivra �la rhn CJI-� �%Ei �bl4 f'>� j !fit c hl fNSp!_('%0P i"jI�AI1i JGY TOWN OF SOUTH WINDSOR TOWN HALL SOUTH WINDSOR, CONN. 06074 DEPARTMENT POLLUTION CONTROL Date . . . . . . . . . The Sanitary Sewer . . . . . Septic System . . . . . ... . . . at . ' . . mt7. . . r.. . . . . . . . . . . . . . . . or lot #. . . . .JG. . . . . . . has been installed and completed in accordance with the Town of South Windsor ordinances and regulations. Accepted a Approved By / Aix_ — Date