HomeMy WebLinkAboutDrain Layers Permit 43 Kent Lane TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL Bhp No.:
South Windsor, Connecticut
List.No.:
DRAIN LAYER'S PERMIT NO 1631
19 / r
Pursuant to written applicatior, permission is hereby granted to the Licensed
/Drain Layer named herein to-perform
the work indicated below at L- � 7 3�C Ct on the
side, between
at mises owned b
whose address i
and to Lay House Drain, Repair House Drain, La -Main Other
y
for occupancy or use,
with e7-kQ Family Units, with acres.
Type of Sewage to be conn cted under this permit:_ �w�
SANITARY SEWAGE ( , INDUSTRIAL WASTE ( ), 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
XSigned
Connection Charge Paid Q censed Drain Layer
Issued by
Tax Collector '
C�Cy
Permit Fee:. Paid $
INSPECTION: Check Number: ��
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
INSPECTOR
N
4" ace
r C'T
p
1
t i
1�
i
1'
A7,
NOTES SOUTH WINDSOR POLLUTION CQXrROL
LOCATION er
OWNER
TYPE OF WORK
DATE PERMIT 163 f PIPE
INSTALLER
INSPECTO DRAWN BYoeA