HomeMy WebLinkAboutDrain Layers Permit 34 Gail Lane TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL
B/P No.:
South Windsor, Connecticut
List No.: _
DRAIN LAYER'.S PERMIT 2213
, 19
Pursuant to written applicatior, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at 6 on the
side, be eenn� -�
at premises owned by 1r '
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
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
Connec ' harge Paid Licensed Drain Layer
--- ----Issued-b - - — -- -- -- -- -- --
ax Collector
Perr Fee: Paid $ _�� AG 2 //C'.1
--------__—__-- —_-- __ - _ INSPECTION: _ Check Dumber:
---- -INITIAL (Sig)
FINAL (Sig)
(Date-5
_ - - (Sig)
INSPECTOR
N
I
a
r
`.J
--_ —NOTES SOUTH WINDSOR POLLUTION CONTROL -
LOCATION o% I ?/,
OWNER
TYPE OF WORK S �� s %d
DATE/0 -;G:7- a PERMIT i PIP ",fu c-
INSTALLER a y�
INSPECTOR C DRAWN BY ' s s=-