HomeMy WebLinkAboutDrain Layers Permit 209 Dogwood Lane ,..,, TOWN - OF SOUTH WIN DSOR
DEPARTMENT OF POLLUTION CONTROL
B/P No.:
South Windsor, Connecticut
List.No.: 6 S2
DRAIN LAYER'S PERMIT NO 1691
19
Pursuant to written application, permission is hereby granted to the Licensed Drain Layer named herein to perform
C
the work indicated below at e { t i t✓C,C= on the
side, between
at premises owned by �e ' Z-ek rc',—no.
whose address is c r XD C.� t'
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 co netted under this permit:
SANITARY SEWAGE ( INDUSTRIAL WASTES ( ), OR (' )
Connection will be made with-
Permit to be issued to law
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. I
SPECIAL CONDITIONS �' n}tin FL
Signed
Connection Charge Paid -Uc—ensea Drain ay
- Issued by
Tax Collector
Permit Fee: Paid $
INSPECTION: Check Number: J 0
INITIAL (Sig)
FINAL (Sig)
APPROVED rJ (Date)
(Sig)
INSPECTOR
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16,5�
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NOTES SOUTH WINDSOR POLLUTION CONTROL
t>4- LOCATION
OWNERt sfc�
TYPE OF WORKS k- <
DATE 1� 71PERMIT cI PIPE L
INSTALLER .S j< s i r
INSPECTOR Ll DRAWN BY