HomeMy WebLinkAboutDrain Layers Permit 97 Beelzebub Road (2) TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL BAP No :
South Wlndsor, Connecticut
List No.: .
DRAIN LAYER"S PERMIT Np 1391
Pursuant to written applicatiioor, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work,indicated below at _/ 7 Is E�LZ V �$ 1M on the
side, between FoSTKR ST 4t uit Q7-GN 4 AA/if
at premises owned by nAitL ��7-400T
whose address is -:52Mt.+Q, GAS ct bd ye--
and to —�LLay 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 ( 1, INDUSTRIAL WASTES .( ), OR ( )
Connection will be made with ye-
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
A- p Signed 10". /Jig
Connection Charge Paid .4 (/ �Hd Licensed Drain Layer
- Issued by
Tax Collector O
_L
Permit Fee:. Paid $ _ .9_
INSPECTION: Check Number: q -2 'S
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
(Sig)
INSPECTOR
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NOTES SOUTH WINDSOR POLLUTION CONTROL
LOCATION ql ?iEELZE
OWNER CIA 01 lz ouT
TYPE OF WORK S W ECZ L PATE K A
DATE S--3-18 PERMIT 139/ PIPE PVC- -
INSTALLER PrDFkg S
INSPECTOR T („' .DRAWN BY