HomeMy WebLinkAboutDrain Layers Permit 212 Laurel Street r TOWN �F -!SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL k'
South"Windsor,Connecticut / ?
'~ .rid DRAIN LAYER'S PERMIT N'O 289
Puisuant to written application, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at .t/ 4 3 on the
— 14
side, between/' at premises Awned.by 8 Al , !`
whose address is
and to Lay House Drain, / Repair House Drain Lay Main, Other
for +�' I 'n.� ise /. occupancy or use
with: !SI•'_ r Family Units, with acres.
Type of Sewage to be connected under this permit:
(SANITARY SEWAGE _ INDUSTRIAL WASTES, OR
Connection will be made with *'` A '
Permit to be issued to X 41 L;
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 extavation. '
SPECIAL CONDITIONS t''io A. Signed-4.�»..:,_...
Connection Charge Paid Licensed Drain Laye
(Sig) Issued by
Tax Collector
Permit Fee: Paid $
INSPECTION: - 't i lF+•
INITIAL (Sig)
FINAL (Sig)
APPROVED "'9- j ,tL-y 073 (Date)
� ,,'•'�C:mot`: , .r, .,../,Q.� (Sig)
INSPECTOR
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NOTES
SOUTH WINDSOR POLLUTION CONTROL
t�or caaw,4 LOCATION La S
A OWNER �
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A = 9.s TYPE OF WORK
g= �� DATE ,o ® 7 PERMIT 2s PIPE Cam" s
INSTALLER _ e
INSPECTOR DRAWN BY