HomeMy WebLinkAboutDrain Layers Permit 400 Foster Street TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL
South Windsor, Connecticut
DRAIN LAYER'S PERMIT N0 26
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Pursuant to written application, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at
- on the
Aside, between .
at premises owned byUlu—
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 toN[
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 cww%
Connection Charge Paid Licensed Drain Layer
Tax Collector (Sig) Issued by y" � art
_ ,.
Permit Fee: Paid $
y
INSPECTION:
INITIAL (Sig)
FINAL _...,._ (Sig)
APPROVED -+ t"s �/l Z'' ? i (Date)
� a
�.
(Sig)
fNSPECTOR
N
0 70
t.,
d
N0� SOUTH WINDSOR POLLUTION CONTROL
LOCATION
OWNER / ° ,'
TYPE OF WORK GvNr✓2c id
DATE TtNc / PERMIT PIPE v 4' C.
INSTALLER RDctm
INSPECTOR CS DRAWN BY flC.S