HomeMy WebLinkAboutDrain Layers Permit 200 Laurel Street Y
_ TOWN OF _SOI)TH WI N DSOR
DEPARTMENT OF POLLUTION CATROL
South Windsor, Connecticut
DRAIN LAYER ' S PERMIT N? 387
19 _
Pursuant to written application, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at 200 jrau"i ,fit
on the
/ .&u side, between Woodlaned & Oale St.
at premises owned by�Phnm�t 7.�eelrn
whose address is
and to X Lay House Drain, Repair House Drain, La Main,, Other
for roaddmtiail
occupancy or use,
with OIl� ��� Family Units, with
acres.
Type of Sewage to be connected under this permit:
SANITARY SEWAGE, INDUSTRIAL WASTES, OR
Connection will be made with ]s iu (6) n]-&tie
Permit to be issued to John A. La®wp
the holder of Drain Layer's License NY9"206488 Permit will expire on Z�
The undersigned Drain Layer hereby agrees to all the terms and conditions set forth on the permit nd the reverse
thereof. Applicant has received Town Permit No. and/or C H D Permit No.
for street excavation.
SPECIAL CONDITIONS Drain layer to
Signed
Connection Charge Paid 0-23-73 Licensed Drain Layer
Per. E. Moniz
(Sig) Issued byRiZD�1 A. Stgi+jt��}�ar. dr
Tax Collector �
Permit Fee: Paid'f.00
INSPECTION: Ch*4k
INITIAL (Sig)
FINAL (Sig)
APPROVED 0 — (Date)
INSPECTOR (Sig)
1
N
22 ,a
2� c'
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NOTES SOUTH WINDSOR POLLUTION CONTROL
C� LOCATION vo
OWNER ` J �,
TYPE OF WORK
DATE - 2ey PERMIT J- PIPE lear> c
/3 2� INSTALLER o»so :
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INSPECTOR '.f' DRAWN BY s