HomeMy WebLinkAboutDrain Layers Permit 129 Kent Lane TOWN OF SOUTH WIN DSOR
DEPARTMENT OF POLLUTION CONTROL
South Windsor, Connecticut
List No.:
DRAIN LAYER'S PERMIT N? 2241
Pursuant to written applicatior, permission is he7�0
ranted to the Licensed.Drain Layer named herein to perform
the work indicated below at )b4 / I'1� �Gt E on the
side, between
at premises owned by- d
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 be 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
�1i,roco
Signed
Connection Charge Paid Licensed Licensed Drain Layer
Issued by
�YP Tax Collector
aa /
Permit Fee:. Paid l S
INSPECTION: Check Number:
INITIAL (Sig) 7`+{�f
FINAL (Sig)
APPROVED - _ - ---- - - (Date)
(Sig) - - - -
INSPECTOR
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NOTES SOUTH WINDSOR POLLUTION COMM,
LOCATION
OW INTER
TYPE OF WORK ,.,,
DATE Y-0:0-5) PERMIT PIPE 6 "`Af c,
INSTALLER
INSPECTOR -- DRAWN BY Qs----