HomeMy WebLinkAboutDrain Layers Permit 530 Buckland Road TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL B/P No.:
South Windsor, Connecticut
List.No.:
DRAIN LAYER'S PERMIT NO 1418
.Tt l/VE a , 19 A
Pursuant to written applicatior, permission is hereby granted to the Licensed Drain Layer named herein to-perform
the work indicated below at Z-AUn on the
� T side, between
at premises owned
whose address is S.A/inG
and to Lay House Draaiivn, Repair House Drain, Lay Main, Other
for .��/.�'DGT���r
occupancy or use,
with Family Units, with acres.
Type of Sewage to be connected under this permit:
SANITARY SEWAGE (5i6,-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 Charge Paid ZD Licensed Dram Layer
ZZ--7 Issued by JFJ >!
Tax Collector
�61
.Permit Fee:. Paid $
INSPECTION: Check Number: =—=�
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
INSP TO (Sig)
N
P1450
_ NOTES SOUTH WINDSOR POLLUTION CONTROL
LOCATION qSO
OWNER
TYPE OF WORK
DATE PERMIT PIPE
INSTALLER
INSPECTOR DRAWN BY