HomeMy WebLinkAboutDrain Layers Permit 91 LeFoll Boulevard TOWN ..OF, SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL B/P No.:
y
South Windsor, Connecticut
List.No.:
DRAIN LAYER"S PERMIT M 1937
J.n/, Z_ , 19.?9
Il
Pursuant to written application, permission is hereby granted to the Licgrlsed Drain Layer named herein to perform
the work indicated below at Z. on the
• side, between
at premi s ow d b �—
whose address is
and to Lay House Drain, Repair House Drain, Lay
Main, Other ,
for zIdd! -' r, occupancy or use,
with Family Units, with acres.
Type of Sewage to,be co cted 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
// a Licensed Drain Layer
Connection Charge Paid �-{00.
G
Issued by
Tax Collector �1"0 0
Permit Fee:. Paid $ _
INSPECTION: Check Number: =1 _ —
INITIAL
(Sig)
FINAL (Sig)
APPROVED -- -------(Date -- ------ — ------- -- -
(Sig)
SP OR
r
N
m
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NOTES SOUTH WINDSOR POLLUTION CONTROL
LOCATION 2 p
OWNER
TYPE 0F WORK LA
DATE 14412172
PERMIT PIPEL 11 ty
INSTALLER
INSPECT DRAWN Y