HomeMy WebLinkAboutDrain Layers Permit 60 Diane Drive TOWN OF SOOTN" WINDSOR
.` DEPARTMENT OF POLLUTION CONTROL
' South Windsor, Connecticut B/P No.:
. _
t_ List No.: _
DRAIN LAYER'S PERMIT p 612
jrAlwez `' ' 19
Pursuant to written applicatior, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at '' I.L._, (:h ; on the
W#Ot~ side, between_
at premises owned by rtt=' e .
whose address is t,,=a .
and to 1, Lay House Drain, Repair House Drain, Lay-Main, Other
r,
for , g `,,f—ttjj occupancy or use,
with Family Units, with acres.
Type of Sewage to be connected under this permit:
SANITARY SEWAGE (A ), INDUSTRIAL WASTES ( ), OR
Connection will be made with � � %1 • . w
Permit to be issued to ¢ ?F` 11 s
the holder of Drain Layer's License No. � a
f y Permit will expire on Aug. 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.
fir•
SPECIAL CONDITIONS Stun
E'.
t
i==
Signea
Connection Charge Paid 6V`10y`,`4 Licensed Drain Layer
: r•R "_ Issued by .. Jr.
Tax Collector
Permit Fee:. Paid $
INSPECTION: Check Number:
INITIAL "- (Sig)
FINAL "- (Sig)
APPROVED (Date)
dd
f (Sig)
INSPECTOR r
A �
7,
i
NOTES SOUTH WINDSOR POLLUTION CONTROL
LOCATION L/,-a �R,
OWNER ,etZ,
TYPE OF WORK S`jmex 4-,j11r;et9Z_
DATE Z a 7 PERMIT `r2 PIPEooVc
INSTALLERGq b�
INSPECTOR -J, DRAWN BY