HomeMy WebLinkAboutDrain Layers Permit 15 Davewell Road TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL B/P No.:
South Windsor, Connecticut
List.No.:
DRAIN LAYER'S PERMIT N? 1659
.can 9zj , 19 �
Pursuant to written applicatior, permission
-ismhereby granted to the Licensed Drain Layer named herein to-perform
the work indicated below at �Zt/L Z/ / on the
side, between
4el ,Izz. 5i AU-41-.A
at premises owned by—
whose ad7",
is
and to ay House Drain, Repair House Drain, Lay Main, Other ,
for / s�/pL �., occupancy or use,
with Family Units, with acres.
Type of Sewage to be connected under this permit:_
e
SANITARY SEWAGE (11<), INDUSTRIAL WASTES .( ), OR ( )
Connection will be made with (D
Permit to be issued to— IAI C,,,
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.2.U/.:f' �a nd/or C H D Permit No.
for street excavation.
SPECIAL CONDITIONS
Signed
Connection Charge Paid V FLicinseff brain Layer
- J J Issued by
Tax Collector
Permit Fee Paid $
INSPECTION: Check Number:
INITIAL (Sig)
FINAL (Sig)
APPROVED — (Date
i
INSPECT
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U de
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NOTES SOUTH WINDSOR POLLUTION CONTROL
oG� LOCATION
OWNER
TYPE OF WORK Q met va!--- v
DATE is PERMIT PIPE �-
INSTALLER
INSPECTOR V«v%r DRAWN BY AZ �