HomeMy WebLinkAboutDrain Layers Permit 62 Elizabeth Street r, = TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL
B/P No.:
South"Windsor, Connecticut r
List No.: _(,�7 4 I
DRAIN LAYER'S PERMIT
O 161
, 19 -72
Pursuant to written applicatior, permission is hereby. ranted to the Licensed Drain Layer named.herein to perform
the work indicated below at j c E' on the
•.7 q
side,_
at premises owned by
whose address is
and to I:ay'House Drain, Repair House Drain, `' Lay Main,' ' `Other
for
occupancy or use,
with , f.: C J Family.Units;,with', acres. .
Type of Sewage.to be connected under this permit:
SANITARY SEWAGE ( ',GIoW- 1 STitIAL W4} TES .( , ), OR
rr
Connection will be made with
Permit to=be issued for
{` Drain,the holder of D erfs '`
t" p`L�Y �rcease hjo, _ ermit will expire-on 19
>' The undersigned Drain,Lawyer he;Eby agrees to all thg.7tgris;Fnd:conditi"ons,set forth �n the permit and the reverse side
thereof: Applicant has received Town Permit No. "' and/or C H-D Peim t'"No.
for street e$c��vation.
SPECIAL CONDITIONS
Signed
Connection Charge Paid ACV 7 j Licensed Drain Layer
� t6L.</`` /�� v 1 Issued by .� ''�
Tax Collector
S Permit Nee:. Paid
INSPECTION: Check Number:
INITIAL (Sig)
FINAL (Sig)
APPROVED 'Z 000 (Date)
_ (Sig)
INSPECTOR
N r ��
6
t � ,
10
10 tzo
wo
NOTES SOUTH WINDSOR POLLUTION CONTROL
LOCATION
OWNER
TYPE OF WORK `
DATE41 Q ,,PERMIT PIPE41leVL
INSTAILIER
INSPECTOR _DHAWN