HomeMy WebLinkAboutDrain Layers Permit 31 High Street TOWN OF SOUTH WINDSOR
DEPARTMENT OF POLLUTION CONTROL
South Windsor, Connecticut B/P No.: _
List No.:
DRAIN LAYER'S PERMIT -
N° 1122
, 19
Pursuant to written applicatior, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at
on the
side, between
at premises owned by
ashose—vddress is
and to Lay House Drain, Repair House Drain, La Mi
Yan, Other
for
occupancy or use,
with Family Units, with
acres.
Type of Sewage to be connected under this permit:
SANITARY SEWAGE ( ), 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
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 Licensed Drain Layer
Tax Collector Issued by
Permit Fee: Paid $
INSPECTION: Check Number:
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
INSPECTOR (Sig)
N
a
i
i
t
I
1
NOTES SOUTH WINDSOR POLLUTION CONTROL
Drawing not to scale. LOCATION 31 H° h Street (Lot 2
OWNER THOMAS Bronislaw S. & Geor ette G.
TYPE OF WORK H uQ2 Connection
DATE PERMIT 1122 PIPE.
INSTALLER Adam (t -206 )
INSPECTOR DRAWN BY '_.