HomeMy WebLinkAboutDrain Layers Permit 265 Diane Drive TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL
B/P No.:
South Windsor, Connecticut /2
List No.: _
DRAIN LAYER'.S PERMIT NO 1346
11-16 ~ 19�
Pursuant to written applicatior, perm i is hereby gra to the Licensed Drain Layer named herein to perform
the work indicat d belo at_ � fh� � on the
"v �� ►' side, betwoen
at premises owned by U c�A e/ 0�7
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 (\Q INDUSTRIAL STES ), 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
Signed %
Connection Charge Paid / en am aye
Issued by (�� �� 2
Tax Collector
�.
Permit Fee: Paid $ C)e"-0
INSPECTION: Check Number: 9V
INITIAL (Sig)
FINAL (Sig)
APPROVED '/d — 7 7 (Date)
/t2v/ /7o� /!l INSPEC R (Sig)
f I 1
.of 66 � .• i � I
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INSTALLER �