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HomeMy WebLinkAboutDrain Layers Permit 52 Foster Road TOWN OF SOUTH WINDSOR DEPARTMENT OF POLLUTION CONTROL B/P No.: South Windsor, Connecticut !2 List.No.: _ DRAIN LAYER'S PERMIT Np 1293 w -- / 19 717 Pursuant to written applicatt�iijor, permission is hereby grante to the Licensed Drain Layer named he to perform the work indicat below at ,G. C�� on the rQ side, betwe n at premises owned by whose address is and to ,X 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 ASTES �s) OR /I Connection will be made with v 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 r Connection Charge Paid !! Lic nse rain Layer —7 / 7 Issued by - a—x Collector / Permit Fee:. Paid$. /y �©0 INSPECTION: Check Number: ............. _. INITIAL (Sig) FINAL (Sig) -_...APPROVED /zoe 7 (Date) t (Sig) INSPECTO 'lam _ __ --- = - 4a1 jy `l LZ t. NOTES SOUTH WINDSOR POLLUTION CONTROL LOCATION e-,r ey OWNER ,,' c1 �i TYPE OF WORK � , Goitr9 DATE - PERMIT/;43 PIPE INSTALLER INSPECTOR DRAWN BY C