HomeMy WebLinkAboutDrain Layers Permit 31 Homestead Drive TOWN OF SOUTH WINDSOR
DEPARTMENT OF POLLUTION CONTROL
South Windsor, Connec B/P No.:ticut
List No.: _
DRAIN LAYER'S PERMIT N'O 2230
L
0
Pursuant to written applicati//or, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below att '6" on the
side, between__
at premises owned by �L/ C '
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 ( ),, 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. an C H D Permit No.
for street excavation.
SPECIAL CONDITIONS
Signed
Connection Charge Paid Licensed Drain Layer
'' "y Issued by
Permit Fee: Paid $
INSPECTION: Check Number:
INITIAL (Sig)
FINAL (Sig)
APPROVED - (Date)
- -_- (Sig) -
- - - INSPECTOR
N
NOTES SOUTH WINDSOR POLLUTION CONTROL
LOCATION 77
' -
OWNER 7-4- /`'T
TYPE OF WORK S-.- Se w�, e rot
DATE 0 o PERMIT p PIPE v C.
INSTALLER
INSPECTOR — DRAWN BY