HomeMy WebLinkAboutDrain Layers Permit 34 Clover Drive TOWN OF SOUTH WINDSOR
DEPARTMENT OF POLLUTION CONTROL
South Windsor, Connecticut B/P No.:
List.No.: _
DRAIN LAYER'S PERMIT -
N° 1414
Pursuant to written applicatior, permission is hereby granted to the Licensed Drain Layer named herein to-perform
the work indicated below at G`L 0 4rA" j� .��l
on the
nld side, between ANDM,4� ,Cp INVIAN T,P1414-
at premises owned by a
whose address is
and to -Lay Ho se 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 C.0 Ve IJ OST 90�+. ' tj
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 B �) Licensed Drain Layer
Issued by
Tax Collector
Pernik Fee:. Paid $ -�
INSPECTION: Check Number:_
INITIAL (Sig)
FINAL
(Sig)
APPROVED_ �((-�Z�7� (Date)
INSPECTOR (Sig)
N
g
r
1 t
F
E ,
NOTES SOUTH HUMQR POLLUTION CONTROL
LOCATION I.oT 41 C`O VF-,e EVE'
OWNER U f A
TYPE OF WO : aus Z0TTC7 3A)
PATE -2z-?8 ARM
IT PIPE '
��TS t LLERC,o veN
INSPECTOR DRAWN BY