HomeMy WebLinkAboutDrain Layers Permit 89 Clearview Drive TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL B/P No.:
South Windsor, Connecticut
List No.:
DRAIN LAYER'S PERMIT N? 2325
ak- , 19k
Pursuant to written application), permission is herebygranted to the Licse��/d Drain La er named herein to perform
the work indicated below at r�o Timber(°r (C� C° C ( /i/l CW
on the
side, between
at premises owned by U S I n 6 (�
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 reverse side
thereof. Applicant has received Town Permit No. and/or C H D Permit No.
for street excavation.
SPECIAL CONDITIONS
y/� d �0^ _ Signed
Connection Charge Paid (JV Licensed Drain Layer
Issued by
] � Tax Collector �l a /Sj—
(((III 7 Permit Fee: Paid $/—_�_._
INSPECTION: Check Number:
INITIAL (Sig) h Or�er5 N r-)
FINAL (Sig) /
APPROVED (Date)
(Sig)
INSPECTOR
N -
s
NOTES SOUTH WINDSOR POLLUTION CONTROL
LOCATION I C r uiFu1
OWNER (/t d.. /� t e ,
TYPE OF WORK a ,._ Se f,�,� �P oA
DATE / PERMIT PIPE "T'V
INSTALLER
INSPECTOR DRAWN BY