HomeMy WebLinkAboutDrain Layers Permit 45 High Ridge Road " p --TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL
South Windsor, Connecticut
DRAIN LAYER' S PERMIT N? 301
19
Pursuant to written application,, �prerrmission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at f w7 _�/ r tom+ on the
side, between pep
at premises owned by P � ,iAI
whose address is
and to �— Lay House Drain, Repair House Drain Lay Main Other
for occupancy or use,
with f, Family Units, with acres.
Type of Sewage to be connected under this permit:
(SANITARY SEWAGE
� ,..y � 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 y' Y
Connection Charge Paid $ Licensed Drain Layer f`
(Sig) issued by
Tax Collector
Permit Fee: Paid $
INSPECTION:
INITIAL (Sig)
FINAL (Sig)
APPROVED @ . { + (Date)
- i 0 +�.wta. - (Sig)
INSP C
i
q
NOTESSOUTH WINDSOR POLLUTION CONTROL
LOCATION
r.r La �
OWNER o
TYPE OF WORK SCo N mar
DATE o _i9- 3 PERMIT 3o1 PIPE ++ `As,
INSTALLER NQP 6 g. o b
INSPECTOR +l- DRAWN BY