HomeMy WebLinkAboutDrain Layers Permit 370 Beelzebub Road s
' TOWN - Of SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL gip No.:
South Windsor, Connectifut '
List No.: _
DRAIN LAYER'S PERMIT N? 2338
19
Pursuant to written applicatior, p fission is hereby grantedto the Licensed Drain Layer named herein to perform
the work indicated below at U �`� on the
61
side, be en
at premises owned by to C%-
whose address is
and to Lay 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 ( j, INDUSTRIAL WASTES OR ( )
Connection will be made with
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
Signed
Connection C e Paid (l`ti_ �b �'� Licensed Drain Layer
Issued by
Tax Collector
Permit Fee: Paid $ _�✓
INSPECTION: Check Number: �1
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
INSPECTOR (Sig)
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NOTES SOUTH WINDSOR POLLUTION CONPROL
LOCATION 4,
OWNER r�`..,tr 1 1''Y! t9• "4
TYPE OF WORK
DATE PERMIT r`?. '. PIPE
INSTALLER !
INSPECTOR C. DRAWN BY C_