HomeMy WebLinkAboutDrain Layers Permit 49 Juniper Lane TOWN OF SOUTH WINDSOR
DEPARTMENT OF POLLUTION CONTROL
South Windsor, Connecticut B/P No.:
List No.:
DRAIN LAYER'S PERMIT NO 1436
119�
Pursuant to written applicat�missI�iaon�is hereby granted to the Licen ed Drain a e L y r named herein to perform
the work indicated below at t u/V1REiG LA/V p f /4
on the
side, between
at premises owned by
whose address is
and to __KL'ay 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 ()O, INDUSTRIAL WASTES .( ), OR ( )
Connection will be made with V
Permit to be issued to
kl-
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
Connection Charge/Paid ��9 Li ensed D sin Layer
Tax Collector Issued by
Qd
Permit Fee: Paid $
INSPECTION: Check Number: % s"` (-----
INITIAL
(Sig)
FINAL (Sig)
-- - - - _
APPROVED
(Date)
INSP TOR (Sig)
< 7
a�
NOTES SOUTH WINDSOR POLLUTION CONTROL
LOCATION r
OWNER
TYPE OF WORK
DATE PERMIT PIPE
INSTALLER
INSPECTOR DRAWN BY