HomeMy WebLinkAboutDrain Layers Permit 61 Dart Hill Road l
TOWN OF SOUTH WINDSOR
DEPARTMENT OF POLLUTION CONTROL B/P No.:
South Windsor, Connecticut G r 6 51
List.No.: _
DRAIN LAYER'S PERMIT NO 1659
.� " , 19 1
Pursuant to written application, per fission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at 6 0. C l'1 �CJ� on the
side, between
at premises owned by ® I/�
whose address is
and to Lay House 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 ( ), INDUSTRIA`LL WASTES .( ), OR ( )
Connection will be made with 1< �—
Permit to be issued to V`i o 5� • !1
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
ff * Signed
Connection Charge Paid u l Z Licensed D ain Layer
- Issued by
Tax Collector
Permit Fee: Paid $
INSPECTION: Check Number: �1 T
INITIAL (Sig)
FINAL (Sig)
APPROVED 7 `/ (Date)
(Sig)
INSP CTOR
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NOTES SOUTH WINDSOR POLLUTION CONTROL
e LOCATION 1 Inca Rd,
OWNER Coon
TYPE OF WORK 4ojl a+eral A W ater<
DATE 1 731-i 5 PERMIT / (o�q PIPE h '' VL
INSTALLER I a..,son v�f f- C, o
INSPECTOR DRAWN BY
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