HomeMy WebLinkAboutDrain Layers Permit 177 Laurel Street TOWN OE ,S.QI TH WI N DSOR
w DEPARTMENT OF POLLUTION CONTROL
South Windsor, Connecticut
' DRAIN LAYER'S PERMIT0 365
Pursuant to written application, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at 1" `1t. on the
i—lA.1 side, between V9640M & Q* St*
at premises owned by
whose
and to XLay House Drain, Repair House Drain, Lay Main, Other
for =011 �1
occupancy or use,
with �a (7) Family Units, with acres.
Type of Sewage to be connected under this permit:
SANITARY SEWAGE, INDUSTRIAL WASTES, OR
Connection will be made with stIll'it
Permit to be issued to
the holder of Drain Layer's License No. Permit will expire on Woo 1973
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 Alt1Rt �� s� 1Y �r
Signed /�. �_ '� � �Y-�-, �•z
Connection Charge Paid Licensed Drain Layer
PWA B. V@011 (Sig) Issued by PAINk As Show ire
Tax Collector
Perm' Fee: aid $ 1��
INSPECTION:
INITIAL — -12f (Sig)
FINAL —7 � (Sig)
APPROVED (Date)
1 INSRG��I'' ''w (Sig)
ate
z2�
l �7
7s"
NOTESSOUTH WINDSOR POLLUTION CONTROL
C� LOCATION 177 L AL s
�v•; OWNER rp P
TYPE OF WORK CzTeC�TE�R�
Q _ 7 DATE PERMIT s- PIPE
INSTALLER
INSPECTOR s DRAWN BY