HomeMy WebLinkAboutDrain Layers Permit 29 Carman Road TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL B/P No.:
South Windsor, Connecticut
List No.:
DRAIN LAYER'S PERMIT N? 2449
� . 5e , 19 JQ/
Pursuant to written applicaa�tiorr, permission is hereby ranted to the Licensed Drain Layer named herein to perform
the work indicated below at �7 C 1 ���
- on the
side, between
at premises owned �^---
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 will expire on 19
The undersigned Drain Layer hereby agrees to all the terms and conditions set forth on the permit and the a side
thereof. Applicant has received Town Permit No. and/or C H D Permit No.
for street excavation.
SPECIAL CONDITIONS
9�a �
Signeu
Connection Charge Paid 4/0 Licensed Drain Layer
Issued by
��Q,p�,• Tax Collector
Permit Fee: Paid $ _2�116_
INSPECTION: Check Number: &��q
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
(Sig)
INSPECTOR
N
�.Is
C- I 4 -
NZOTES SOUTH WINDSOR POLLUTION COWROL
LOCATION
OWNER
TYPE Or WORK
DATE r PERMIT PIPE
INSTALLER
INSPECTOR DRAWN BY