HomeMy WebLinkAboutDrain Layers Permit 26 Imperial Drive (2) TOWH *OF SOUTH WINDSOR
DEPARTMENT OF POLLUTION CONTROL
South Windsor, Connecticut
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DRAIN LAYER'S PERMIT
O 188
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Pursuant to written application, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at 26lopwr1-o AM,Y* 4- on the
side, between
at premises owned by
whose address is fllfillO
and to _XLay House Drain, Repair House Drain, Lay Main, Other
for romiddat1.a occupancy or use,
with tua (1) Family Units, with acres.
Type of Sewage to be connected under this permit:
.SANITARY SEWACF.. ) INDUSTRIAL WASTES, OR
Connection will be made with SdAP+13i" (Ef") P&V*C*
Permit to be issued toffadmd r. j.4.1t,0 dAA Kars Il Wjso NoBafttlo f
the holder of Drain Layer's License No. II ",? . Permit will expire on JVIT 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 ft21A LaAr to muh. ] and 6adI='11 SqM e
Signed `,.. •: $:
Connection Charge Paid Licensed Drain Layer r,
1.
ftr U Mmis (Sig) issued by WAS i. Jr. �f
Tax Collector
Permit Fee: Paid $1�f.tlE3
INSPECTION: +fit *Qdbirr
INITIAL (Sig)
FINAL """ (Sig)
APPROVED.- 10 We 1973 (Date)
(Sig)
OR
N
NOTES SOUTH WINDSOR POLLUTION CONTROL
DrawiAg Aot to mcale. LOCATION 26 Ire e 'al Drive
OWNER Kermeth L. Jacksom
TYPE OF WORK S(-wer ConnectioA
DATE _ 3 PERMIT 188 PIPE6t' Pla
INSTALLER Ph9l' W9-2o6912)
INSPECTOR ME DRAWN BY ME
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