HomeMy WebLinkAboutDrain Layers Permit 43 Birch Road TOWN OF SOUTH WINDSOR
DEPARTMENT OF" PO*tL&r11ON CONTROL
South Windsor, Connecticut
DRAIN LAYER'S
AYER S PERMITp 480.
Pursuant to written application, permission is hereby granted to the Licensed Drain Layer named Herein to perform
the work indicated below at__4�
on the
side, between
at premises owned by
whose address is
and to Lay House Drain, Repair House Drain, La Main Other
yM ,
for
+� occupancy or use,
with Family Units; with
acres.
Type of.Sewage to be connected under this permit:
SANITARY SEWAGA INDUSTRIAL WASTES, OR
Connection will be made with dttwa «l ----------------
Permit to be issued to kft;'L,•'�iWIt,
the holder of Drain Layer's License No. - Permit will expire on ' 1 The undersigned Drain Layer hereby agrees to a-11 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_ - ' umm e-
Signed
Connection Charge Paid Licensed I�in Layer
16 *oft (Sig) Issued by •• StIdWaffillup
Tax Collector
Permit.Fee: Paid i
SM
INSPECTION:
INITIALC ��9 J� ;' �, 7
FINAL (Sig)
�:7,
APPROVED (Date)
INSPECTOR (Sig)
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NOTES SOUTH WINDSOR POLLUTION CONTROL
LOCATION
OWNER • P017
TYPE OF WORK
DATE r- PERMIT � PIPE 7711:1.
INSTALLER
INSPECTOR ti' DRAWN BY r"';