HomeMy WebLinkAboutDrain Layers Permit 1497 Main Street DEPARTMENT OF POLLUTION CONTROL
B/P No.:
South Windsor, Connecticut p
List.No.:
° 1963
19
Pursuant to written applicatt`ior, permission is hereby ranted to the Licensed rain Layer named herein to'perform
the work indicated kAIow at ..'
=� on the
side, between
at premises owned b v— r
whose addresses
and to Lay+House.Urain, Repair'house Drain Lay`Main Orher'
for occupancy or use,
withf Family Units,:with acres.
Type of Sewage to be'connected under this permit:
SANITARY SEWAGE ,(,',.NDUSTR•IAL WASTE ,.(f )�OR ( )
Connection_wi11_be-made-w,ith----- — — - ---'�...
Permit to,be iseued
the holder of D,tain Laygl's License No. will expire on 19
The undersigned Drain,Layer hereby agree�,to all tho"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,exgavation. a
SPECIAL CONDITIONS C I,.r i .,a'#•}�_ r :_
is Signed .` s
Connection Char'ge Paid d"Drain Layer "
Issued by
Tag Collector / 51&3
Permit Fee:. Paid $
INSPECTION: Check" Number:
INITIAL (Sig)
FINAL (Sig) .
APPROVED E -* ; t'' '. , (Date)
-
- - - � � • (Sig
-- INSPECTOR.
N v
a i
9
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NOTES SOUTH WINDSOR POLLUTION CO ROL
LOCATION
OWNER '
TYPE 0 WORK 4
DATE PEWIT „G PIPE elr�
INSTALTER s.
ir
INSPECTOR DRAWN BY.