HomeMy WebLinkAboutDrain Layers Permit 112 Beelzebub Road TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL gip No.:
South Windsor, Connecticut G
List.No.: _
DRAIN LAYER'S PERMIT NO i511
I9—_
Pursuant to written applicatior, permission is hereby granted to the Licensed Drain Layer named herein to-perform
the work indicated below at Jet &-rl-7. s 23669 A48 on the
side, between
at premises owned W00.00DC
whose address is
and to -C,_Lay House Drain, Repair House Drain, Lay Main, Other
for AEsf-VE/V T/xi occupancy or use,
with Family Units, with acres.
Type of Sewage to be connected under this permit:
SANITARY SEWAGE ()iL), INDUSTRIAL WASTES .( ), OR ( )
Connection will be made with
Permit to be issued to 9/\/
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 -
Connection Charge Paid 4Licensed Drain Layer
Issued by
Tax Collector
OD
Permit Fee:. Paid $
INSPECTION: Check Number: fl
INITIAL (Sig)
FINAL Aa/115 (Sig)
APPROVED (Date)
(Sig)
INSPECTOR
i
NOTES SOUTH WINDSOR POLLUTION CONTROL
LOCATION //Z ,fee lz etc 1s ,
OWNER • W o c� c o c..
TYPE OF WORK
DATE t o-3-17 PERMIT S 1 PIPE ' p
INSTALLER avrsov
INSPECTOR DRAWN BY