HomeMy WebLinkAboutDrain Layers Permit 78 Elizabeth Street TOWN OF SOUTH WINDSOR
DEPARTMENT OF POLLUTION CONTROL gip No.:
` South Windsor, Connecticut
List No.:
DRAIN LAYER'S PERMIT NO 1960
��- 19
Pursuant to written applicatior, ission is hereby gran reed to the Licensed Drain Layer named herein to perform
the work indicated below at on the
side, etween
at premises owned by
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 ( ), 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
Signed ^
Connec ' Charge Paid Lic sed Drain Layer
Issued by
Tax Collector
.Permit Fee:. Paid $
INSPECTION: Check Number: �w
INITIAL (Sig)
FINAL (Sig)
APPROVED /Z 3 7 (Date)
INSPECTOR (Sig)
N - �
6
ail
- 1
K3
NOTES SOUTH WINDSOR POLLUTION CONTROL
LOCATION
OWNER
TYPE OF WORK
DATE/ ,,, /! PERMIT l9tlgo PIPE
INSTALLS
INSPECTOR DRAWN BY