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TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL
B/P No.: 6-I
4C-7 South Windsor, Connecticut
List.No.: S w/O Z e
4,4.3 _
DRAIN LAYER'S PERMIT 100
14 May 19 76
Pursuant to written application, permission is hereby granted to the Licensed Drain Layer named herein to'perform
the work indicated below at 48.Brook Street (.�nr ZZlo) on the
west side, between Farmstead Drive. & Meadow Road,,-,.
at premises-owned by KOSCIW, John. A. & Joanne D.
whose address is Same
and to X Lay House Drain, Repair House Drain, Lay Main, ; Other
for residential occupancy or use,
with one (1) Family Units, with acres.
Type of Sewage to be connected under this permit:
SANITARY SEWAGE (.X), INDUSTRIAL WASTES'.( ), OR
Connection will be made with six—inch (611) plastic pjli� to'-'-,a 1AterhT known as Sta `5me*7 at a
depth of 6.01+.
Permit to be issued to: - Richard A. Bouley
the holder of Drain.Layer's License No. W9-2058P-4 Permit will expire on 14 Jul' 19 76;
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 Charge Paid .0.5_13-.76 Licensed' rain v
Re c• qT5 Issued by Melvin Edwards, Jr.
Tax Collector
Permit Fee:. Paid $
INSPECTION: Check Number: 28 S 1L.....
INITIAL a /7 e ®93.Z (Sig) .
FINAL �� /5�, (Sig)
APPROVED /7 1q4 /976 (Date)
24 A-Z—&�
S CTOR (Sig)
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Nil
Myra F'r
of 411 oz. �ti 62
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NOTES SOUTH WINDSOR POLLUTION CONTROL
Drawing not to scale. LOCATION 48 Brook gtreet
Q OWNER KOSCIW John A. & Joanne D.
TYPE OF WORK Houlle
DATE PERMIT im PIPE(.
'Z 7 INSTALLER Boule (W -20 824)
INSPECTOR DRAWN BY
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wher tt would xtce3i hetconhectiort:by drawing a, line fz^arM:the house ar ti� Y
the septic tank ta,theEGnatItn to tt�e street. Also £ t }
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the Towct Eng�neri� Department ` '
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