HomeMy WebLinkAboutDrain Layers Permit 29 LeFoll Boulevard TOWN--.OF, SOUTH WINDSOR
DEPARTMENT OF POLLUTION CONTROL
B/P No.:
South Windsor, Connecticut
List.No.: --il- --7-0 (7 .
DRAIN LAYER'S PERMIT N? 1827
Zr) , 19.E
Pursuant to written applicatior, permi sion is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at
on the
side, between 44
at premises owned by
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 FASTES .( ), 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
o a� T/ Signed
C ec ion Charge Paid d0 .o Licensed Drain ayer
Issued by
Tax Collector V1,1 Dl7 9
Permit Fee:. Paid $
INSPECTION: Che Number•
INITIAL (Sig)
FINAL (Sig)
A-PPROVED--- ---- ----- - -���- -- -- -(Date)
(Sig)
INSPECTOR
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AV
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NOTES SOUTH WINDSOR POLLUTION CONTROL
LOCATION e o/I71?IL/dp
OWNER
TYPE OF WORK /n A/ `' VL lam. efc,
DATE VZZ7 PERMIT /B'a PIPE
INSTALLER
INSPECTOR P41 DRAWN BY ��