HomeMy WebLinkAboutDrain Layers Permit 1025 Foster Street .} TOWN OF SOUTH WINDSOR
DEPARTMENT OF POLLUTION CONTROL
B/P No.:
South Windsor, Connecticut
List.No.: _ 0 ('12
DRAIN LAYER'S PERMIT NO i820
Pursuant to written applicatioor, permission is herety-granted to the Licensed Drain Layer named herein to perform
the work indicated below at / f, �� �� G { S T on the
side, between
at premise owned by L=^S + Ile- k 'n /p r-S j
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 rob�enected`under this permit:
SANITARY SEWAGE ( , INDUSTRIAL WASTES ( ), OR ( )
Connection will be made with
Permit to be issued to atok WN y L vtA S
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
/y3S�
Signed cam.
Connection Charge Paid �l�D. License Dr in ayer
G¢;
- Issued by _
Tax Collector
Permit Fee:. Paid .00
_
INSPECTION: Check Number:
- - - INITIAL (Sig)
FINAL (Sig)
- ------------- _ (Date)
(Sig)
IN P C O
L/ I
7,5
..............
I
NOTES SOUTH WINDSOR POLLUTION CONTROL
LOCATION -
OWNER
/ TYPE OF WORK
"6 DATE P AMIT
INSTALLER
INSPECTOR DRAWN BY