HomeMy WebLinkAboutDrain Layers Permit 21 Edgewood Drive TOWN OF SOUTH WINDSOR
DEPARTMENT OF POLLUTION CONTROL B/P No.
Li
South Windsor, Connecticut st `'�
.No.: �J
DRAIN LAYER'S PERMIT NO 1981
Pursuant to written applicatior, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at oZ �UG c,O a � �.
on the
side, between
at premises wned by &Iddl0 11 cG ✓i
whose address is-
and to Lay House Drain, Repair House Drain, -Lay`Main, Other
for �� ~�Or. /i occupancy or use,
with Family Units, with acres.
Type of Sewage to be connected under this permit:
SANITARY SEWAGE (INDUSTRIAL WASTES ), OR ( )
Connection will be made with rj
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
4-0
v Signed
Connection Charge Paid d''0, Licensed Drain Layer
ssued by Zlez�)
Tax Collector
Permit Fee:. Paid $ _ 16-7_
INSPECTION: Check Number: 00
INITIAL (Sig) 3 2�CG Lac C C I
FINAL (Sig)
APPROVED F 0 (Date)
(Sig)
INSPECTOIC
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¢ 2
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NOTES SOUTH WINDSOR POLLUTION CONTROL
LOCATION Z I 606p W,,02 tqXjVe
OWNER
TYPE OF WORK
DATE - a PERMIT PIPE t0 A
INSTALLER c
INSPEJCTOBDRAWN
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