HomeMy WebLinkAboutDrain Layers Permit 14 Dogwood Lane TOWN OF SOU I N DSOR `
DEPARTMENT OF POLLUTION CONTROL
South Windsor, Connecticut
sot.6400
DRAIN LAYER'S PERMIT ; NO} 241
Pursu pt tq written applical Qn, p�Fm s�pn: s'.h�reby grantgd tc>.1��LAC, esi,h�re�n.to perform
the work indicate'tb�i'� f a + x '
4v t on the .
y� T N! ,
T yc
at premises owned by
whose address is i
;(s ay
and to L H ouse D.
rain, Repair House Drain,for
cu
with
,,., ;a p- Fancy or use,
i+am,il� its with ' ' i' aeeg
z}
Type of Sewage to be connected under this permit
SANITARY SEWAGE , «� E INDUS-I'RIAL.W00111,�OR ,Y,
Connection will be made with
Permit ttd be'.issued r
the holder of Drain_Layr? License Nb __� expire ins: f 19
The undersigne&Drain-•.Lay-enitereby�"a-g'recs:.to all ihe,terms�and•,tQnditio. s-,$ t.Iorth QiActh side
thereof. Applicant has received Town Permit No. and/or C H D Permit No.
for street exc vAfjonz - „{,
SPECIAL. 00OS_
)1,3tJ - _
lo
t.t rh `Ls_.,lb
g thy���� ' Signed ;
Connection Charge Pa - � - • -
;� - � _ .�,. is .1� n� 7�ala
Tax Collector (Sig) Issued by
- PerFee: Paid $
INSPECTION:
INITIAL (Sigy
FINAL (Sig)
APPROVED ; mot. (Date)
44
t �
} ' (Sig)
INSPECTOR
T-ram
D 0,
Ay
6 -
NOTES SOUTH WINDSOR POLLUTION CONTROL
LOCATION i L
OWNER
TYPE OF WORK
DATE PERMIT PIPE
INSTALLER
INSPECTOR DRAWN BY