HomeMy WebLinkAboutDrain Layers Permit 47 Deming Street mow
TOWN OF S0#Ir
� WI N DSOR
DEPARTMENT OF UTION CONTROL
South Windsor, C61nec#icut
, , �►
DRAIN LAYER'S PERMIT No
278
19= -
Pursuant to written application, permission is hereby granted to the Licensed Drain Layer named herein to,perform
the work indicated below at on the
rim side, between
at premises owned by_
whose address is
and to X Lay House Drain, Repair House Drain, Lay Main; Other
for '
occupancy or use,
with we 0) Family Units, with acres.
Type of Sewage to be connected under this permit:
SANITARY SEWA.GF) 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. and/or C H D Permit No. .
for street excavation.
SPECIAL CONDITIONS
• d
Signed
Connection Charge Paid Licensed Drain,Layer
Pw X* (Sig) , Issued by
Tag Collector - r
Permit Fee: Paid $
INSPECTION: '.&-016 # h ►
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
(Sig)
INSPECTOR
o
•S/
NOTES SOUTH WINDSOR POLLUTION CONTROL
SCAtE: t "= s+s+P.QoX•4� ' LOCATION 4 &SET•
OWNER drAc
TYPE OF WORK Sr
A = 34.s DATE «e-��-�3
o _ z3 s PERMIT Zug PIPE-
'
---� NSTALLER
INSPECTOR DRAWN BY 1�—