HomeMy WebLinkAboutDrain Layers Permit 21 Homestead Drive a TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL Bhp No.:
South Windsor, Connecticut 0 9
List No.: _
DRAIN LAYER'S PERMIT N0 2229
� y
Pursuant to written apps"ion 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
whose address 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 ( j, 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
7 ^' Signed
Connection Charge Paid Licensed Drain Layer
- 4z,C&�ldg� Issued by -
Tax-GGe4ee{er �
Perm F e: Paid $
INSPECTION: Check Number:
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
— --- - - (Sig) --
INSPECTOR
N
r
r
�v.
t
NOTES SOUTH WINDSOR POLLUTION CONTROL
LOCATION 7;L `
OWNER /"`
TYPE OF WORK S, Glr e i '�-
DATE / - O PERMIT PIPE t. '''-`A/c-
INSTALLER
INSPECTOR DRAWN BY