HomeMy WebLinkAboutDrain Layers Permit 30 Dogwood Lane TOWN OF SOUTH WINDSOR
DEPARTMENT OF POLLUTION CONTROL
South Windsor, Connecticut B/P No.:
List No.: _ —
DRAIN LAYER'S PERMIT 649
Pursuant to written applicatior,permission is hereby granted to the Licensed Drain Layer named he to perform
the work indicated below at q (tuj
on the
side, between at premises owned by O A"ev a 6,
whose address is
and to X 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 (7), INDUSTRIAL WASTES .( ), OR ( )
Connection will be made with 31X 4A41h yuotis piw
Permit to be issued to 41W H121a
the holder of Drain Layer's License No. Permit will expire on 1,1f1 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
yy` sf R f
Signed
Connection Charge Paid icensed Drain Layer
Issued by Jar "luitit-
Tax Collector
Permit Fee: Paid $ _ R
INSPECTION: Check Number: 1
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
7
(Sig)
INSPECTOR
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V
6
b
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NOTES SOUTH WINDSOR POLLUTION CONTROL
LOCATION So ,
OWNER
TYPE OF WORK
DATE Via 174 PERMIT 6 f PIPE
INSTALLE
INSPECTOR DRAWN BY