HomeMy WebLinkAboutDrain Layers Permit 10 Homestead Drive TOWN OF SOUTH WINDSOR
DEPARTMENT OF POLLUTION CONTROL
B/P No.:
South Windsor, Connecticut
List No.: _
DRAIN LAYER'S PERMIT NO 2339
7 L Lt a rf" , 19(
Pursuant to written applicatior, permissionQisqh�erhyranted to the{ / granted
/�' Licensed Drain Layer named herein to perform
the work indicated below at �('�1-- �6 �� �lt� I"
on the
side, between
at premises owned A-1
Whose addreass 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 ( ), 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
Connection Charge Paid 1' 0.d U -Licensed Drain Layer
:�N 1 E. lCtliy►t.
Tax Collector Issued by
yz Ce
Permit Fee:. Paid $ _
INSPECTION: Check Number:
INITIAL (Sig)
FINAL (Sig)
- --- -- - APPROVED— -
(Sig)
- INSPECTOR - _ --
N
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NOTES SOUTH WINDS R OLLUTION CONTROL
LOCATION
OWN7-R
TYPE OF UTORK
DATE `S S' I PERMIT 33 PIPE (p �
INSTALLER f
INSPECTOR DRAWN BY r C_...