HomeMy WebLinkAboutDrain Layers Permit 165 Farmstead Drive TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL
B/P No.:
South Windsor, Connecticut �/
List No.: _
DRAIN LAYER',S PERMIT NO 1263
19�C�
Pursuant to written applicat/ior, permissio is hereby anted t the Licensed Drain Layer named herein to perform
the wgk iinnd-ica low at (a f� � `� on the
�l, C% / side, betty en
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 (A INDUSTRIAL W TES
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 �
Connection Charge Paid f�U Licensed Drain Layer
-2 Issued by
Tax Collector
Permit Fee:. Paid $
INSPECTION: Check Number: ,
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
(Sig)
INSPECT R
r t
J�
h
1
c:-
NOTES SOUTH WINDSOR POLLUTION CONTROL
LOCATION A =' i-. l 7
OWNER, _
TYPE OF WORK
DATE o.- - PERMIT- i "' PIPE
INSTALLER
INSPECTOR ' DRAWN BY
9
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