HomeMy WebLinkAboutDrain Layers Permit 66 Glenwood Road TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL B/P No.:
South Windsor, Connecticut / O
List.No.:
DRAIN LAYER'.S PERMIT 1252
6-/a 19 77
Pursuant to written application, per s ion is hereby grantW
Licensed Drain Layer named herein to perform
�� �e GCJQ '
the work indica below on the
crec U side, between //' /
at premises owned by Q/ &i �
whose address is
and to "�LLay 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 (\Z, INDUSTRI WASTES . ), OR ( )
Connection will be made with -a H ��
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
Connection Charge Paid O9 Licensed Drain Layer
`/- 77 Issued by
Tax Collector
r-,
Permit Fee:. Paid $ _AS''G d
INSPECTION: Check Number: _-30 7-
INITIAL (Sig)
FINAL (Sig)
APPROVED �/ /����� (Date)
(Sig)
INSPECTOR
i t .
t
1
P
r
s.
,
N
r � r
f f y
y
s
E
—NOTESSOUTH WINDSOR POLLUTION CONTROL
r ,
LOCATION ` t_
d ; OWNER
TYPE OF WORK 1
DATE. PERMIT f PIPE
�`. INSTALLER , )a
INSPECTOR ^,,, DRAWN BY ;�