HomeMy WebLinkAboutDrain Layers Permit 141 Beelzebub Road ' TOWN OF .40UTH WI N DSOR
DEPARTMENT 00 POLLUTION CONTROL B/P No.: '
South Windsor, Connecticut >
List No.: ± '°'� !�6'e_'
DRAIN LAYER'S PERMIT 502
Pursuant to written applicatior, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at 140"zol t ttwr l3) on the
ength side, between AIM & at*r Sto
at premises owned by J*hb T G
whose address is
and to X Lay House Drain, Repair House Drain, Lay-Main, Other
for m4ddential -
occupancy of use,
with one W Family Units, with acres.
Type of Sewage to be connected under this permit:
SANITARY SEWAGE ( ), INDUSTRIAL WASTES .( ), OR
Connection will be made with tuck (6) Vi"t3a 1*
Permit to be issued to jobn low"=
the holder of Drain Layer's License No. w9-MW8 Permit will expire on S w 15 192
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 nwo
L
Signed
Connection Charge Paid 11/13/7.5 Licensed Drain Layer
+ '+ Wnis Issued by WPh Aw 9 1YlA S Jr-
Tax Collector
Permit Fee:. Paid $
INSPECTION: Check Number: _ k? 11
INITIAL ,' �� =:` E} (Sig)
FINAL (Sig)
APPROVED A01d�. (Date)
(Sig)
k INSPECTOR
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Go
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NOTES SOUTH WINDSOR POLLUTION CONTROL
LOCATION Iq/
14 i) ',,, OWNER
TYPE OF WORK
iJ /gzTERMIT PIPE
INSTALLER z��
INSPECTOR R S DRAWN BY s