HomeMy WebLinkAboutDrain Layers Permit 36 Juniper Lane TOWN OF SOUTH WINDSOR
DEPARTMENT OF POLLUTION CONTROL
South Windsor, Connecticut B/P No.:
List.No.:
DRAIN LAYER'-S PERMIT -
N° 14'73
Pursuant to written applicatior, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at ,
he
lOT Z y
side, between t on
at premises owned by___=�2✓�/�1
whose
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 ( , INDUSTRIAL WASTES ( ), OR
Connection will be made with
e
Permit to be issued ;o
the holder of Drain Layer's License No,
Permit will expire on The undersigned Drain Layer hereby agrees.to all the terms and conditions set forth on t 19
he permit and the reverse side
thereof. Applicant has received Town Permit No.
for street excavation. and/or C H D Permit No:
SPECIAL CONDITIONS
Connection Charge Paid �? Signea
Licensed Drain Layer
Issued by
Tax Collector
�-
Permit Fee: Paid $
INSPECTION: Check Number:
INITIAL (Sig)
FINAL (Sig)
APPROVED
r.: (Date)
PE OR s (Sig)
' 4
N
NOTES SOUTH WINDSOR POLLUTION CONTROL
LOCAT ION Lo-1-
OWNER
TYPE OF WORK
DATE PERMIT ILI? PIPE
INSTALLER
INSPECTOR I DRAWN BY