HomeMy WebLinkAboutDrain Layers Permit 57 LeFoll Boulevard TOWN OF SOUTH WINDSOR
.•• '' DEPARTMENT OF POLLUTION CONTROL
B/P No.:
South Windsor, Connecticut
List No.: _ o
DRAIN LAYER'S PERMIT NO 1524
51 �vd �- ,�> , 19 �x
Pursuant to written applicatior, p rmission is hereby granted t the Lice Drain La a ed h re' to perform
the work indicated below at on the
side, between <'
at premises owned by
whose address is
and to Lay House Drain, Repair House Drain, e Lay Main, _Other
for occupancy or use,
withFamily Units, with acres.
Type of Sewage to be con cted under this permit:
SANITARY SEWAGE ( INDUSTRIAL WASTES . ), R ( )
Connection will be made with �/J �� lC.
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
N411
Signed
Cgnnert��n Charge Paid �(7 Licensed DraiqXayer
Issued by
Tax Collector
Permit ee: Paid $ /S 00__ L-0� l�
INSPECTION: CPhck Number , 71D
e
INITIAL (Sig)
FINAL (Sig)
------ - — --- ------
-----APPROVED-- --- ----— ------- ------ -
- ---- - - (Date)
INSPEC
N
6 .0
f �
NOTES SOUTH WINDSOR POLLUTION CONTROL
LOCATION
OWNER -:r-,
TYPE OF WORK
DATE ' PERMIT PIPE �i
INSTALLER
INSPECTO DRAWN B