HomeMy WebLinkAboutDrain Layers Permit 2 Clover Drive TOWN OF SOUTH WI"NDSOR
DEPARTMENT OF POLLUTION CONTROL .
South Windsor, Connecticut B/P No.:
List No.: _ �/ t'S0
DRAIN LAYER'S PERMIT NO 1462
[�� Y V:/ , 19
Pursuant to written applicatior, permission is hereby granted to the Licensed Drain Layer named herein to"perform
the work indicated below at '� . i9VC/'� � .(.0� 2
on the
side, between
at premises owned by_ u �
whose address is
and to Lay House Drain, Repair House Drain, Lay-Main, Other
for n E 1 EyV/T/L '
occupancy or use,
with �/(J`E 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 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 y
Connection Charge Paid �r�®� Licensed Dr -Layer
Issued by
Tax Collector
Permit Fee: Paid $ _
INSPECTION: Check Number: Z
INITIAL (Sig)
FINAL (Sig)
APPROVED _Pi — 7y (Date)
IOWA (Sig)
IN E OR
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NOTES SOUTH WINDSOR POLLUTION CONTROL
LOCATION -i 2 L�OVLr- Ll,
OWNER U a--fz
TYPE OF WORK f reuse Cnnnrc.�,c,n
DATE PERMIT ►H 6z PIPE N P
INSTALLER
INSPECTOR :;7F DRAWN BY C, K.