HomeMy WebLinkAboutDrain Layers Permit 22 Clover Drive (2) TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL
South Windsor, Connecticut B/P No.:
List No.: _ 'P/0
DRAIN LAYER'S PERMIT NO 1464
I , 19 760
Pursuant to written applicatior, permission is hereby granted to the Licensed Drain Layer named he to perform
the work indicated below at 22 Cad��� ��. Lp j � L on the
side, between
at premises owned by
whose address is
and to Y. House Drain, - Repair House Drain, Lay Main, Other
for LeE,-S, 7Jia�71/T/al,
- - occupancy or use,
with Family Units, with acres.
Type of Sewage to be connected under this permit:
SANITARY SEWAGE ()i ), INDUSTRIAL WASTES ( ), OR ( )
Connection will be made with All Py
Permit to be issued to � y
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 �Licen Drain Layer
Issued by
Tax Collector
Permit Fee: Paid $
INSPECTION: Check Number:
INITIAL (Sig)
FINAL (Sig)
APPROVED — (Date)
(Sig)
S CTOR
I �
`t
t
1
NOTES SOUTH MIMSO t POLLUTION CONTROL
- -
LOCATION L o+ 4 4 Clo e r r i
OWNER
TYPE OF WORK Houser Ccsnre'c,+Ion
Dt1 S- 1-'�8 PERMIT 146L PIPE v
IN� .ACERB
INSPECTOR G,-r, DRAWN. BY c,