HomeMy WebLinkAboutDrain Layers Permit 70 Clover Drive TOWN OF SOUTH WINDSOR
DEPARTMENT OF POLLUTION CONTROL
South Windsor, Connecticut B/P No..-
List.No.: _
DRAIN LAYER'S PERMIT / .�
N° 1495
Pursuant to written applicatior, permission is hereby granted to the Licensed Drain Layer named he to-perform
the work indicated below at () !'f V_& y
on the
side, between y
at premises owned by /�
whose address is
and to Lay House Drain, Repair House Drain, La -Main,Man, Other
for "S/Ddc /T119L ,
�� occupancy or use,
with_ Family Units, with
acres.
Type of Sewage to be connected under this permit:
SANITARY SEWAGE (X), 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
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 Licensed Dr Layer
79r Issued by
Tax Collectors
Permit Fee: Paid $ _LJ
INSPECTION: Check Number: L
INITIAL (Sig)
FINAL
(Sig)
APPROVED ' (Date)
INS TO (Sig)
N
y �GEG
7,¢�gNsFegmC
220 /5•s�-®
31.S
NOTES SOUTH WINDSOR POLLUTION CONTROL
LOCATION Q4OVE/L og. LoT 311
70 OWNER a
TYPE OF WORK #V&s Ceti rT10 A)
1:f�d DATE B-31- 7cg PERMIT / PIPE G " V
INSTALLER R ,p
INSPECTOR DRAWN BY