HomeMy WebLinkAboutDrain Layers Permit 43 Imperial Drive M -
t - TOWN OF 1H
f � � W N DSOR
DEPARTMENT OF POLLUTION CONTROL
South Windsor, Connecticut
YA*t %*1 8-01.3
DRAIN LAYER'S PERMIT
O 198
fl� 3S � 19
Pursuant to written'application,'permission.is hereby granted to the Licensed Drain Layer named herein to perform
the work igdicat d below ati�' +6f1 on the
MINA wide, between : ftrW . dud Md
at premises owned by
whose address ri.. air
and to _ ` Lay House Drain, Repair House Drain; Lay Main, _.Other
for Plil�h/ lf�i� ccupancy or use,
� y
with Family Units,, with f. acY,61S.
Type of Sewage to be c.onneeted.under this permit:
�,v,;
(SANITARY SEWAGE- INDUSTRIAL .WASTES, OR
Connection.will-fie ma e with
Permit to be issued to 70 fta%
the holder of Drain"Layer's License No. `Permit will expire on,. 1-4 1973 .
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 � ' t- *
' Signed a 1�6
Connection Charge Paid Licensed Dram Layer
t _ .;:.>•. (Sig) ' :Issued->by ilt" s 4F41
Tax Co1l464tor
Permit Fee: Paid $ 1 el0
INSPECTION:
INITIAL w (Sig)
FINAL (Sig)
APPROVED (Date)
- (Sig)
I✓�T ,
46 �,
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c Ito
1 ,Qr'
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NOTES SOUTH WINDSOR POLLUTION CONTROL
Drawing not to sole. LOCATION 43 Imperial Drive
1 2 OWNER William Lavoie
A 35.6 --- TYPE OF WORK Sewer Connection
B $.o 36.6 DATE o -1 -73 PERMIT 19$ PIPE 6,, Plast.
INSTALLER Phalin W -2o6 12)
C --- 2$.6 INSPECTOR HWL DRAWN BY ME