HomeMy WebLinkAboutDrain Layers Permit 20 Homestead Drive _ r TOWN OF SOUTH WINDSOR
DEPARTMENT OF POLLUTION CONTROL
South Windsor, Connecticut B/P No.:
List No.: _:: ' O K3
DRAIN LAYER'S PERMIT ; N? 2193
190
Pursuant to written applicatior, permissionQisjh�erehyranted to the Licensed DrainD SLayer named herein to perform
the work indicated below at eC /
on the
side, between
at premises owned by QJ/7 j6J
whose address is
and to Lay House Drain, Repair House Drain,
Lay-Main, Other
for
with occupancy or use,
Family Units, with
acres.
Type of Sewage to be connected under this permit:
SANITARY SEWAGE ( ), INDUSTRIAL WASTES _( ), OR
Connection will be made with
j
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.
for street excavation, and/or C H D Permit No.
SPECIAL CONDITIONS
i
177- Signed •
onnection Charge Paid
Licensed Drain Layer
Tag Collector Issued by
P yr� 4X
Permit Nee: Paid $
INSPECTION: Check Number:
INITIAL
(Sig)
FINAL (Sig)
APPROVED - - -- --- (Date) _ - - - —- ---
INSPECTOR--. (Sig) - -- -
Vie'* ldCONCRETE
PIPE COMPANY, INC.
WAUREGAN,CONNECTICUT 06387 203 564 3371
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