HomeMy WebLinkAboutDrain Layers Permit 30 Jacques Lane TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL B/P No.:
Li
South Windsor, Connecticut 3
st No.: _
DRAIN LAYER'S PERMIT ` ? 2181
30 Jac" ' 19
Pursuant to written applicatior, permission is h by granted to a Licensed Drain Layer named herein to perform
the work indicated below at ;17 on the
side, betwe
at premises owned by�.
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
Connect' harge Paid L,/�l Licensed Drain Layer
Issued by
Tag-Collector
/CCUU
Permit Fee: Paid $
INSPECTION: Check Number: Z_.a�►
INITIAL (Sig)
FINAL (Sig)
---TPPR VED-� (Date)
-
INSPECTOR - -
Q DEV FROM TOP C FL0612
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GF OC W41K
NOTES SOUTH WINDSOR POLLUTION CONTROL
LOCATION LOT y u 0
OWNER �"N'J 1V C
TYPE OF WORKS w ct v
DATE — o PERMIT I PIPE " vc
INSTALLER Ca e_ C.
INSPECTOR l DRAWN BY