HomeMy WebLinkAboutDrain Layers Permit 63 Elizabeth Street TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL
B/P No.:
South Windsor, Connecticut
List.No.:
DRAIN LAYER'S PERMIT NO 1983
19 S70
Pursuant to written applicatior, peIssion is hereby gra t d to the Licensed Drain Layer named herein to perform
the work indicated below at on the
side, between
at premises owned by 'a 1 1160f /-/ NA e-
whose address is
and to Lay House Drain, Repair House Drain, Lay-Main, Other
for occupancy or use,
with ty) L Family Units, with acres.
Type of Sewage to be connected under this permit: T
SANITARY SEWAGE �-
K")-,-INDUSTRIAL WASTES' .( ), OR ( )
Connection will be made with - ( tr'/'
Permit to be issued to *-t
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
Dj Signea
ConnectioryCh r�e Paid V60 Licensed Dram Layer
Issued by el
Tax Collector 10k3 a
Permit Fee: Paid $
INSPECTION: Check Number:
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
SPE O (Sig)
N
t t �
•14
NOTES SOUTH WINDSOR POLLUTION CONTROL
LOCATION
OWNER
TYPE OF WORK elf
DATE -' PERMIT PIPE
INSTALLER
INSPECTOR DRAWN BY