HomeMy WebLinkAboutDrain Layers Permit 459 John Fitch Boule (2) )f� TOWN OF SOUTH WI N DSOR
G DEPARTMENT OF POLLUTION CONTROL
�. . South Windsor, Connecticut
List.No.:
F
DRAIN LAYER'S PERMIT N? 1644
Pursuant to written applicatior, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated Belo at on the
.! side, between
t
at remises owned b
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 7"D
connected under this permit:
SANITARY SEWAGE (� , 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 ONDITIONS
1
r
Signed
Connection Charge Paid d Drain Layer
Issued by
Tax Collector
Permit Fee:. Paid $ r�����5�
INSPECTION: Check Number: -41- 9. 3 -
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
/ (Sig)
SP CTO
• yr.
I
i
r� - --- -06
---- --- John F �c JIv
NOTES SOUTH WINDSOR POLLUTION CONTROL
LOCATION q 3oNhl FITCH ,BL.vo.
OWNER
TYPE 0 WORK
DATE — E IT PIPE /Y &I
INSTALLER
INSPECTOR. b0 DRAWN BY Q, L a K