HomeMy WebLinkAboutDrain Layers Permit 1121 Main Street _ TOWN ---O - SOT-TH7-WI-N DSOR--_ -
DEPARTMENT OF POLLUTION CONTROL BAP No.:
South Windsor, Connecticut
List No.: �
DRAIN LAYER'S PERMIT - - -
N° 1842
Pursuant to written applicatior, permission is hereb granted to the Licensed Drain Layer named herein to p�erf'or—m
the work indicated below at on the
side, betwe
at premises owned b (�
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
I Signed
Connec ' 40
0 arge Paid �p Licensed Drain yer
Issued by
Tax Collector
Permit Fee: Paid $ l✓ —__ / d
�( INSPECTION: Check Number:
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
(Sig)
INSPECTOR
4�.
Qj
Fo7ll,
i
NOTES SOUTH WINDSOR POLLUTION CONTRO
LOCATION // 2.1
OWNER
TYPE OF O _ S ,
DATE PERMIT PIPE /
INSTALLER o
INSPECTOiMAD DA PkDRAWN BY