HomeMy WebLinkAboutDrain Layers Permit 129 Beelzebub Road o. TOWN OF SOUTH WI N DSO'R
DEPARTMENT 0 POLLUTION CONTROL
South Windsor, Connecticut e `J
DRAIN LAYER'S PERMIT ND 479
Octe 22 ' 1923
Pursuant to written application, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at 129 Boom lbub PA.( L-T A) on the
SOU0 side, between--1UJjj1;t= & Ay= $te
at premises owned ka
whose address is ft 10
and to x Lay House Drain, Repair House Drain, Lay Main, Other
for 24mide ual occupancy or use,
with on* (1) Family Units, with acres.
� 1
Type of Sewage to be connected under this permit:
SANITARY SEWAGE), INDUSTRIAL WASTES, OR
Connection will be made with 81X tab (6) JUBUO. ILI*
Permit to be issued to p#tO Qnft t!
the holder of Drain Layer's License NOW,01naQ2293 Permit will expire on Dill. 2,2 19 PST
The undersigned Drain Layer hereby agrees to all the terms and conditions set forth on the permit and the reverse site-4—
thereof. Applicant has received Town Permit No. and/or C H D Permit No.
for street excavation.
SPECIAL CONDITIONS_ D II laid' t0 pup, crush AAA baek= sepUc ti*
Signed
Connection Charge Paid $10/16/13 Licensed Drain Layer
y. -'?+r*X* Knit (Sig) Issued by j* A: SUVItI tthor Jr*
Tax Collector
Permit Fee: Paid $
INSPECTION: 01140�k 0 ..,._..,.' f
,l
INITIAL (Sig)
FINAL ) / .c �' ` ._� t� 7 e 0 ,� (Sig)
T
APPROVED ,i r (Date)
(Sig)
INSPECTOR
N
D
t
19
1
NOTES SOUTH WINDSOR POLLUTION CONTROL
LOCATION 42 9
OWNER
TYPE OF WORK
DATE QcT ? PERMIT 7i PIPE e.cam
INSTALLER !/,' Cov,4:wS.,�
INSPECTOR OV:" DRAWN BY s