HomeMy WebLinkAboutDrain Layers Permit 8 Fox Meadow Lane TOWN OF SOUTH WINDSOR
DEPARTMENT OF POLLUTION CONTROL j
B/P No.:
South Windsor, Connecticut / /6 �/ •�
List.No.:
DRAIN LAYER'-S PERMIT NO 168
C1
' 19
Pursuant to written applicatior, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at Ix /V 1 �G1(r:Le� �C on the
side, between tt
at premises owned by �f' 1' Ci C�'7��. , C i1-i ri k'7
whose address is—
and to ..�ay 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 -�) USTRIAL WASTES ( ), OR ( )
a
Connection will be made with_ 4� /0(f '<
Permit to be issued to C2
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.
§PECIAL CONDITIONS—
Signed
�
Connection Charge Paid f'3 Ip 1 _ , ensed Drain Layer
Issued-by �f- _ _ -- --- TT— -
ax o ecfor
100
Permit Fee: Paid $
_. INSPECTION: Check Number: ,
INITIAL ram, (Sig)
FINAL . (Sig)
IP,
�0 ( (Date)
(Sig)
INSPECTOR
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0
(1L
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- -IOrES SOUTH WINDSOR POLLUTION CONTROL
LOCATION Fox Nt e_(,,78oLo
OWNER Itlt)v\;rx '?owran
4 t t TYPE OF ORK h 0,+oaI( I� -e�-r� cr. r
DATE " 7 PERMIT /(, PIPE 6 PV~
INSTALLER S 5r c `t-ew K
INSPECTOR DRAWN BY .