HomeMy WebLinkAboutDrain Layers Permit 117 Brook Street TOWN OF SOUTH WINDSOR
DEPARTMENT,,OF POLLUTION CONTROL B/P No.:
South Windsor, Connecticut ,� j 1 .2-a
List.No.: _
DRAIN LAYER'S PERMIT N? 1841
19
Pursuant to written applicatior, permission is hereby grante to the Licensed Drain Layer named herein to perform
the work indicated below at /n O on the
side, betwee 7�
at premises owned by—
whose address is
and to Lay House Drain, Repair House Drain, Lay Main, Other
forte! occupancy or use,
with Family Units, with acres.
Type of Sewage to be connected under this permit:
SANITARY SEWAGE (INDUSTRIAL ASTES ,,/), R
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
�,y ` Signed a1Yj � Y
Connectio ge Paidj-�` Z /�� Li used Drain Layer
- Issued by r
Tax Collector
Permit Fee:- Paid $ ��__ 8-13 0
INSPECTION: Check Number:
INITIAL (Sig)
FINAL (Sig)
APPROVED Q (Date)
� (Sig)
INSP TOR
N
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2_1-
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NOTES SOUTH WINDSOR POLLUTION CONTROL
�v LOCATION a
OWNER
TYPE OF WORK
DATE ;�, °PE IT PIPE ly�,
! L INSTALLER ` ✓ v_
INSPECTOR' „� '�'. RAWN BY r`