HomeMy WebLinkAboutDrain Layers Permit 48 Clover Drive E-
TOWN OF SOUTH WINDSOR
r DEPARTMENT OF POLLUTION CONTROL
South Windsor, Connecticut B/P No.:. /
List No.: _ 6 �
DRAIN LAYER',S PERMIT -
N° 1415
:SANE 2 Z , 19 2&-
Pursuant to written applicatior, permission is hereby granted to the Licensed Drain Layer named herein to-perform
the work indicated below at 1-) L-QVL�� DAP I U�
on the
side, between
at premises owned by
whose address is
and to Lay House Drain, Repair House Drain,
Lay-Main, Other
for
occupancy or use,
withjlvouclFamily Units, with
acres.
Type of Sewage to be connected under this permit:
SANITARY SEWAGE 0& 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.
for street excavation. and/or C H D Permit No.
SPECIAL CONDITIONS
Connection Charge Paid Signed
4� Licensed Drain Layer
Tax Collector Issued by
Permit Fee:. Paid $
INSPECTION: Check Number: ��_
INITIAL (Sig)
FINAL
(Sig)
APPROVED (p L f (Date)
(Sig)
INSPECTOR
_ f �
l
ES SOUTH WM()R POLLUTION CONTROL
LOCATiON 1.vT D l
OTntNER _
WORE USA C MLO 1b
is-E.—M
? PERMIT PIPE ''R -
INSPECTOR DRAWN BY 77