HomeMy WebLinkAboutDrain Layers Permit 1417 Main Street TOWN OF SOUTH WINDSOR
DEPARTMENT OF POLLUTION CONTROL
B/P No.:
South Windsor, Connecticut
List.No.: 7 .e4=
--- - - - - - - DRAIN LAYER'S PERMIT -
N° 1905
1L�.�1 • 3 C) , 19
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Pursuant to written applicatior, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at on the
side, between
at premises owned b
r
whose address is
and to Lay House Drain, Repair House Drain, Lay Main, Other
r
for occupancy or use,
with Family Units, with acres.
Type of Sewage two be�con�nected under this permit: �,ee �
SANITARY SEWAGE (�1�; INDUSTRIAL WZSS ), ORConnection will be made with 4V l�
Permit to be issued to
the holder of Drain 4 yer's Licepse 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
/SD�
Signedl�.GeG�� iLv�— r
Cohnbctioh Charge Paid y�0 Licensed Drain Layer
Issued by---�-1 P�,ra L xl�4"C'Z�
Tax Collector �0 aV V
Permit Nee: Paid $�S v
INSPECTION: Check Number:
INITIAL (Sig)
FINAL (Sig)
APPROVED ® / .(Date)
a;
— - - (Sig)
INSPECTOR
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N
- �/vo
NOTES SOUTH WINDSOR POLLUTION CONTROL
/ LOCATION
OWNER
TYPE OF WORK 1,�
... DATE /Q Q PE T PIPE
INSTALLER r
INSPECTO _ DRAWN BY