HomeMy WebLinkAboutDrain Layers Permit 21 Beechnut Lane TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL B/P No.: A* . tt
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South Windsor, Connecticut f
List No.:
DRAIN LAYER'S PERMIT . �a '708
29 Oc tab: , 19 24
Pursuant to written applicatior, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at 21 ",a;resit Lnvig ( + season T on the
ft"t side, between „ $Wok dye % d
at premises owned by
whose address is
and to X Lay House Drain, Repair House Drain, Lay-Main, Other
for re"dential
occupancy or use,
with 0A0 Family Units, with acres.
Type of Sewage to be connected under this permit:
SANITARY SEWAGE (X), INDUSTRIAL WASTES .( ), OR ( )
Connection will be made with -1n01 0") RjWtjV Idyt
Permit to be issued to A i ier�
the holder of Drain Layer's License No. "_M6074 Permit will expire on_ 29 er 19 '"4.
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 ': Licensed Drain Layer
�* Issued by tt 1 _'"A )z x '.
Tax Collector
Permit Fee Paid $
INSPECTION: Check Number: A.R.G.
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INITIAL /; � (Sig)
FINAL (Sig)
APPROVED 2 �' "'` C> (Date)
(Sig)
INSPECTOR
N
C�
NOTES SOUTH WINDSOR POLLUTION CONTROL
LOCATION
OWNER
TYPE OF WORK ,
DATE 10 PERMIT 20 PIPE�),!
INSTALLER �� �...,•
INSPECTOR DRAWN BY
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