HomeMy WebLinkAboutDrain Layers Permit 131 Laurel Street TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL
B/P No.:
Soutk Windsor, Connecticut L
List.No.:
DRAIN LAYER'S PERMIT NO 1504
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_ CAN lb AC
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
Signed 4 \
Connection Charge Paid S ID Licensed Drain Layer
9- 8 - Issued by A.
Tax Collector
Permit Fee: Paid $
INSPECTION: Check Number:
INITIAL (Sig)
FINAL (Sig)
APPROVED
.a - (Date)
(Sig)
INSPECTOR
i
i
ce.
NOTES SOUTH WINDSOR POLLUTION CONTROL
LOCATION
OWNER la'��-BEapT A NTaK
TYPE OF WORK I-AodSE C iV 6c-7-)AN
DATE 9-/y- 79 PERMIT 619V PIPE G" ?VC
INSTALLER W►
INSPECTOR DRAWN BY