HomeMy WebLinkAboutDrain Layers Permit 24 Brian Road TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL ,
B/P No.-..
South Windsor,Connecticut /3 a a-
List No.: _
DRAIN LAYER'S PERMIT N? 2248
19
l f,
Pursuant to written appllii�c�attior, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at
on the
side, between
at premises owned by
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 ( , INDUSTRIAL WASTES .( ), OR ( )
Connection will be made with
Permit to be issued to
the holder of Drain Layer's License No. Permit *ill expire on 19
The undersigned Drain Layer hereby agrees to all the terms and conditions set forth on the permit and the reverse side s
thereof. Applicant has received Town Permit No. and/or C HD Permit No.
for street excavation.
i
SPECIAL CONDITIONS
Signed
Con ectiion�CCharge Paid �,��, g Licensed Drain Layer
Issued by
r Tax Collector C �.
Permit Fee:. Paid $ ._
INSPECTION: Check Number:
INITIAL (Sig)
FINAL (Sig)
APPROVED l O� (Date)
r
(Sig)
PECTOR
N
1 �j. fir;
1
NOTES rA � SOUTH WINDSOR POLLUTION CONTRO
LOCATION ;?
s, r.
OWNER
- TYPE OF WORK
DATE l �,U PERMIT P PE
INSTALLER 77 77
INSPECTOR _ DRAWN BY ` C--