HomeMy WebLinkAboutDrain Layers Permit 65 Lewis Drive TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL B/P No.:
South Windsor, Connecticut
List No.: _ 5� S',
DRAIN LAYER'S PERMIT NO 1965
, 19P
Pursuant to written applicatior, perm sion is hereb5granted to the Licensed Drain Layer named herein to Iperform
the work indicated below at on the
side, betw en
at premises owned b d-
whose address is—
and to Lay House Drain, Repair House Drain, Lay Main, _Other
for .r r -� occupancy or use,
with 4Y t Family Units, with acres.
f
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
Connecti barge Paid / '7 S'll �_ icensed Drain Layer
oe
Issue
ax Collector
2
Permit Fee:. Paid $
INSPECTION: Check Number: ,
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
INSPECTOR (Sig)
N
022
i
ash
.zz
NOTES SOUTH WINDSOR POLLUTION CONTROL
LOCATION
OWNER h 1v
TYPE OF WORK
DATE —ohs -7y PERMIT %G ' PIPE j,7 777777
INSTALLER
INSPECTOR 3p DRAWN BY '>