HomeMy WebLinkAboutDrain Layers Permit 69 Farmstead Drive x,i 4'
TOWN- OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL
B/P No.: .
South Windsor, Connecticut -
List.No.• _S GO-7,6
DRAIN LAYER'S PERMIT
O 938
1 �s , 19 _
Pursuant to written applicatior, permission is hereby granted to the Licensed Drain Layer,named herein to perform
the work indicated below at x � d �nT 30� on the
side, between
at premises owned by `
whose address is
and to L Lay House Drain, Repair House Drain, Lay.Main, Other
for occupancy or use,
with Family Units,with acres.
wType.9f Sewage to,be connected under this permit: .
SANITARY SEWAGE ' ), INDUSTRIAL`WASTES .( ), OR
Connection will be made with am X& "Ague him
Permit to be issued to �A': "P` isd
the holder of Drain Layer's License No.- V_#N9_2" 4 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
Connection Charge Paid _ Licensed Drain er
Issued by a
Tag Collector
Permit Fee:. Paid $ _
s
INSPECTION: Check Number:
— --- — -- - - ---—--3
INITIAL (Sig)
FINAL
APPROVED t i'j (Date)
(Sig)
4 INSPECTOR
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NOTES SOUTH WINDSOR POLLUTION CONTROL
LOCATION (o
OWNER
TYPE OF WORK
DATE ' PERMIT ljq PIPE
INSTA LE
INSPECTOR DRAWN BY
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To help locate your sewer connection on-the main line, please sho"sv
where you would like the connection by drawing a line From the house or ' ftft
the septic tank to the main line in the street. Also- install stakz in '
yard �
to indicate line as shown.on sketch. I F.you have any doubt please contact,
the Town Engineering Department.
Please draw important in Formation such as driveways, large trees
and other obstructions._
PLEASE MAIL THIS FORM IMMEDIATELY TO: ,F
4
JAMES S. MINOES & ASSOC., INC. s`
_ The Exchange
Farmington Avenue ti
- Farmington, Connecticut O6032
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