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HomeMy WebLinkAboutDrain Layers Permit 606 Foster Street TOWN OF SOUTH WI N DSOR DEPARTMENT OF POLLUTION CONTROL B/P No.: South Windsor, Connecticut �r pQ 3 List.No.: DRAIN LAYER'S PERMIT N? 1924 , 19. Pursuant to written application, permission iss hereby granted to the Licensed Drain Layer named herein to perform the work indicated below at (0 U (o 4-Pr- S on the side, between / at//premises owned by - J a),-eS A , 4 �jPs whose address is S� O S�1 f Pt- and to House Drain, Repair House Drain, Lay-Main, Other for occupancy or use, with Family Units, with acres. Type of Sewage to be c t. /onneected under this permit: SANITARY SEWAGE ( )�INDUSTRIAL WASTES .( ), OR ( ) Connection will be made with - - Permit to be issued to kLah-.2 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 ao. 0 0 Licensed Drain Lay - - O O2'ft - � Issued by Tax Collector Permit Fee: Paid $ � INSPECTION: Check Number: y/w INITIAL (Sig) r FINAL (Sig) APPROVED (Date) (Sig) INSPE TOR N 1 7 Q Vc.a 01 � j a i -TOES SOUTH WINDSOR POLLUTION CONTROL LOCATION & © r OWNER TYPE OFWORK DATE RMIT PIPE INSTA INSPECTOR D WN BY