HomeMy WebLinkAboutDrain Layers Permit 19 Juniper Lane • a TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL
B/P No.:
South Windsor, Connecticut
List No.:
DRAIN LAYER'.S PERMIT NO 1450
1 q T AiPOL �.,u r�kj �u�y `l , l ��
Pursuant to written applicatior, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at G1/VIP� .C.ftw� SOT !O on the
�Sr9UTlf side, between
at premises owned by 77rJ4 N
whose addLess is
and to Lay House Drain, Repair House Drain, Lay-Main,` Other
for
occupancy or use,
with /)/(f E Family Units, with acres.
Type of Sewage to be connected under this permit:
SANITARY SEWAGE OO, INDUSTRIAL WASTES .( ), OR ( )
Connection will be made with__ P V
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
gZAConnection Charge Paid ��97 LicenseLd Drain ayer
Issued by
Tax Collector
Permit Fee:. Paid $ _
INSPECTION: Check Number: � --
INITIAL (Sig)
FINAL (Sig)
_ - - - - --- APPROVED - sL��'�7� - -(Date)
(Sig)
ECTOR
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NOTES SOUTH WINDSOR POLLUTION CONTROL
LOCATION ,-) L o+ :0- to
OWNER 7-+- M
TYPE OF WORK 44o,st 4-ton
DATE `-I-2 Ll-' & PERMIT 1 Sc) PIPE 6
INSTALLER K+- K.
INSPECTOR . T, DRAWN Bye. K.