HomeMy WebLinkAboutDrain Layers Permit 177 Homestead Drive TOWN OF SOUTH WINDSOR
DEPARTMENT OF POLLUTION CONTROL
South Windsor, Connecticut B/P No.:
List No.: D U
DRAIN LAYER'S PERMIT NO 23.08
1 �
) 19
Pursuant to written app�icatiorpermisslokhVeore_b`y, gra)nted to the Licensed Drain Layer named herein to perform
c-r i
the work indicated below attt-L
on the
side, between
at premises owned by `i ip` JJW%%t,24
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. and/or C H D Permit No.
for street excavation.
SPECIAL CONDITIONS
Y
3 -3u -kJ Signed
Connection Charge Paid _ Q6, Licensed Drain Layer
Issued by
Tax Collector ,
Permit Fee:. Paid $ _���G✓_
INSPECTION: Check Number-
INITIAL �-
(Sig)
v
FINAL (Sig)
PPROVED - --
-- - � (Date)
--- -- --- - _ (Sig)
INSPECTOR
y
N
f
DOTES SOUTH WINDSOR POLLUTION ONTROL.
LOCATION
OWNER
TYPE OF WORK
DATE - �2o671PERMIT PIPE
INSTALLER
INSPECTOR S" C vDRAWN BY -�