HomeMy WebLinkAboutDrain Layers Permit 30 Hayes Road TOWN OF SOUTH WINDSOR
DEPARTMENT OF POLLUTION CONTROL gip No.:
South Windsor, Connecticut
List.No.:
DRAIN LAYER'S PERMIT N? 1610
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Pursuant to written applicatior, permiss'on is hereby, granted tot Licensed Drain Layer named herein to-perform
the work indicated below at on the
side, between
at premises owned b ^�
whose address is
and to - Lay House Drain, --Repair House Drain, Lay-Main, Other
for IZZ occupancy or use,
with �,�'amily Units, with acres.
Type of Sewage to be connected under this permit:
SANITARY SEWAGE (!/j, INDUSTRIAL WASTES .( ), R ( )
Connection will be made with VC
.
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 7j' Licensed Drain'Layer
Issued by
Tax Collector
Permit Fee:. Paid $ �1LL
INSPECTION: Check Number: 47 1 K
INITIAL (Sig)
FINAL (Sig)
_ - --- - ----__ _ - -APPROVED �120 % -- _ - --: (Date)._
(Sig)INSPECTOR
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NOTES SOUTH WINDSOR POLLUTION CONTROL
LOCATION j 0 AIAX
OWNER
TYPE OF WORK S
DATE 411w4 P PERMITZ&oO PIPE
INSTALLER fiD40 tA1jg &6j,,1SJ<j
INSPECTOR4, dftWN BY zqWAOPbCX