HomeMy WebLinkAboutDrain Layers Permit 26 Edgewood Drive TOWN OF SOUTH WINDSOR
. DEPARTMENT OF POLLUTION CONTROL
B/P No.:
South Windsor, Connecticut 3�-/
List No.. 6,_
DRAIN LAYER'S PERMIT NO 2236
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Pursuant to written applicatior, permission is hereby granted t the Licensed Drain Layer named herein to perform
the work indicated below at J& toel ) on the
side, between.
at premises owned by �-) N t fvt/S t° p e 0
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 ( j, INDUSTRIAL WASTES .( ), 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
l`m
Signed
Connection Charge Paid �� Licensed Drain Layer
Issued by
Tax Collector 1182
_ 0�
Pe mih Nee: Paid $ �5_�
INSPECTION: Check Number:j2-L
INITIAL (Sig)
FINAL (Sig) J
APPROVED ��`� n (Date)
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INSPECTOR (Sig)
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NOTES SOUTH WINDSORYOLLUTION CONrROL
LOCATION ' '. { Lly
OWNER :0;F, F--
TYPE OF WORK <- 1., ....�r �f..
DATE _ "C}PERMIT .> PIPE
INSTALLER V e-
INSPECTOR `- DRAWN BY