HomeMy WebLinkAboutDrain Layers Permit 102 Kent Lane TOWN OF SOUTH WINDSOR
DEPARTMENT OF POLLUTION CONTROL
South Windsor, Connecticut B/P No.:
List No.:
DRAIN LAYER'S PERMIT � O 2240
.166 , 19
Pursuant to written applicatior, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at on the
side, between
at premises owned by Tf 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 to a 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 CONDITIONS '
tf Ib�(O Signed
Connection Charge Paid cl bO Licensed Drain Layer
Issued by
Tax Collector �ay0
Permit Fee:. Paid $
INSPECTION: Check Number:
INITIAL (Sig) 7--1
FINAL (Sig)
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SPECTOR
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NOTES SOUTH WINDSOR POLL ION CONTROL
LOCATION b f 3 Ly
OWNER Td--
TYPE OF WORK S- 54,-,le v a r
DATE 1 -a 1- F4 PERMIT <l PIPE vc
INSTALLER
INSPECTOR C- DRAWN BY S.