HomeMy WebLinkAboutDrain Layers Permit 25 Imperial Drive TOWN OF UTH WI N DSOR
DEPARTMENT OFPOLLUTION CONTROL BAP No.: 76_C
South Windsor,Connecticut
List No.: sbf O8 1.
DRAIN LAYER'S PERMIT
N? 1126
03 AiiLna st f 19 76
33 3 Pursuant to written applicatior, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at Pti 7rii ari al Drive ( mot 11) on the
east side,between Deming Street E c,z1-de�sac.
at premises owned b IiAVt3J�, Qla
whose address is same
and to X Lay House Drain, Repair House Drain, Lay Main, Other
for resi.den t.ial occupancy or use,
with one (-1) Family Units, with acres.
Type of Sewage to be connected under this permit:
SANITARY SEWAGE INDUSTRIAL WASTES .( ), OR ( )
_Connection will-be-made with-six-inch__(-6'9_ gj:-peto a lateral-known-ab,-ata. 4+46t6r-at--a— -- - _ —
-F
deL)th of 8,011.
Permit to be issued to sldam i•Ti sni ewski
the holder of Drain Layer's License No. . W9-20u55() Permit will expire on 0_'.11 October 19 /6.
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. 7fr ,f, �r
Connection Charge Paid 08-0-76 Licensed Drain Layer ` 1
2EI __ `_ 1006 Issued by Melvin Edwards, Jr.
Tax Collector
Permit Fee:. Paid $ _�9 00
INSPECTION: Check Number:
INITIAL C, f '- !44 c pp (Sig)
FINAL 9-t-, Z421 itI1%:cAV-,--o a4 Ce 4Z3 (Sig)
APPROVED o4-Aue�usT 1974b (Date)
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-- - - - ((Sig) -
INSP OR -
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NOTES SOUTH WINDSOR POLLUTION CONTROL
LOCATION 25 Imperial Drive (Lot 11)
OWNER HAVENS Angela
TYPE OF WORK House Connection
DATE PERMIT 1126 PIPE
INSTALLER Adam (W -206 )
INSPECTOR DRAWN BY