HomeMy WebLinkAboutDrain Layers Permit 145 Diiane Drive TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL
South Windsor, Connecticut B/P No.:
List No.: _. 0
DRAIN LAYER'S PERMIT N? 2170
, 190
Pursuant to written application,,l on
permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at Y� 'Do Yl 10 'Dr on the
side, between )^
at premises owned by_0 bb: � tc ef'5
l
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
bee connected under this permit:
SANITARY SEWAGE (,.x INDUSTRI 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 atld the reyerse side
thereof. Applicant has received Town Permit No. and/or C H D Permit No.
for street excavation.
SPECIAL CONDITIONS
Signed
Connection Charge Paid d Drain Layer
-- '� Issued by
Tax CalcFer- �3 !?U
Permi Fe Paid $ 1z _ _
INSPECTION: Check Number:
INITIAL (Sig)
FINAL Sig)
F
2
APPROVED kDate)
(Sig)
INSP CTOR
N
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r 7 r `�S
� S
r C) '
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NOTES SOUTH WINDSOR POLLUTION CONTROL
LOCATION
OWNER Xcl 6 e! q�-e. 5
TYPE OF WORK
DATE PERMIT IPE
INSTAL R C
INS ECT R DRAWN BY