HomeMy WebLinkAboutDrain Layers Permit 165 Homestead Drive TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL
`
South Windsor, Connecticut B/P No.:
List No.:
DRAIN LAYER'S PERMIT N'O 2288
• ,�Gc,'(',`v o� 19
Pursuant to written applicatio�r,permission iis� hTT
by granted to the Licensed Drain Layer named herein to perform
the work indicated below at_&6 't17"Y tP , � d►/ 5 on the
side, between
at premises owned by ' L
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
Signed
Connection Charge Paid Licensed Drain Layer
Issued by
Tax Collec/t'or
Permit Fee:. Paid $
INSPECTION: Check Number: - 4::1�6
INITIAL ��
(Sig)
FINAL (Sig)
APPROVED (Date)
- (Sig)
INSPECTOR
N �
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NOTES SOUTH WINDSOR POLLUTION C NrROL
LOCATION S- �, *-
OWNER
TYPE OF WORK ,
DATE — -- 9'( PERMIT .,: `.. ,? a PIPE C
INSTALLER iyr .ev
INSPECTOR S- C_ DRAWN BY �_