HomeMy WebLinkAboutDrain Layers Permit 27 Gail Lane TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL
B/P No.:
South Windsor, Connecticut
List No.: _
DRAIN LAYER'S PERMIT N? 2335
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4 , l91l
a A .L aA'e.': '
Pursuant to written applii/cauor, permission iss hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below ate /iry_ Ce on the
side, between
at premises owned by
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. fi
for street excavation.
SPECIAL CONDITIONS
4'
/(n
06 - ..
-5-S Signed
Connection Charge Paid n.1)0 Licensed Drain Layer
'LL Issued b - --- - --- -------- - - ---- - -- - -----— —
ax Collector� _/► 6141 ^ Permit Fee: Paid $
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Check eck Number:,
- - _
- — INITIAL._.. _ - ,,. .� _ (Sig)
FINAL (Sig)
;f; (Date)
_ (Sig)
INSPECTOR
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1
1
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4
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NOTES SOUTH 14INDSOR POLLUTION COWROL -- -
LOCATION
OWNER
TYPE OF WORK crk, S .sac^� ter ,
DATE ( PERMIT '` :'> PIPE
INSTALLER C d LJ, '
-_ INSPECTOR -S - DRAWN BY