HomeMy WebLinkAboutDrain Layers Permit 48 Imperial Drive TOWN OF SQUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL
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South'Windsor, Connecticut B/P No.:
List No.: _
DRAIN LAYER' S PERMIT N? 591
�s�rrr 4 1 1 9 2_
Pursuant to written applicati//or, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at C_ 48 on the
O.l —defte side, between_ . u 1i►s �, �, +.lui�l �
at premises owned by
whose address is
and to Y Lay House Drain, Repair House Drain, Lay Main, Other
for �Es�.ie!4?;! t1
occupancy or use,
with f1ree Family Units, with acres.
Type of Sewage to be connected under this permit:
SANITARY SEWAGE (X ), INDUSTRIAL WASTES ( ), OR ( )
Connection will be made with 1113LVAI=At` veewv.
Permit to be issued to
the holder of Drain Layer's License No: Permit will expire on A19* IJ 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
aT'. P4• �''w�+�Isf Issued by
Tax Collector
F hn
Permit Fee: Paid $ _ -_• ___
INSPECTION: Check Number:
INITIAL f/ `7f - „�s', 4. ',t t: I (Sig)
FINAL tfr' > fj (Sig)
APPROVED .,:. - ` ;j -7.
L'/ (Date)
(Sig)
INSPECTOR '+�
4
NOTES SOUTH WINDSOR POLLUTION CONTROL
LOCATION f !qL
OWNER C i%OL 6��1i'L��iPS r�ivc
TYPE OF WORK `Fi�wr twit/Y�,.' o✓
DATE r ERMIT -,s IPE ✓�
INSTALLER O
INSPECTOR DRAWN BY