HomeMy WebLinkAboutDrain Layers Permit 1051 Foster Street TOWN OF SOUTH WINDSOR
R DEPARTMENT OF POLLUTION CONTROL
South Windsor, Connecticut Li ' /-
st.No.: �2
DRAIN LAYER'S PERMIT NO 181
oc 19 7 y
Pursuant to written applicatior, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at f U 6� on the
side, between
at premises owned by S l 0-
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 ( j, INDUSTRIAL WASTES .( ), OR
Connection will be made with-6 �v L
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
ar Signea
Conne arge Paid , f Licensed 1jr—adn Layer
- Issued by
---Tax-Cr4lector
Permit Fee:. Paid $ l5'�
INSPECTION: Check Number: , JAE 2--
INITIAL (Sig)
FINAL (Sig)
APPROVED __ Z
(Date)
(Sig)
INSPECT
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k
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NOTES_ SOUTH WINDSOR POLLUTION CONTROL -
LOCATION ".s f -5 7
OWNER S a /�
TYPE OF WORK 5u
DATE PERMIT PIPE
INSTALLER
INSPECTOR DRAWN BY