HomeMy WebLinkAboutDrain Layers Permit 52 Mark Drive TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL B/P No.:
South Windsor, Connecticut -3
List No.: _
DRAIN LAYER'S PERMIT N0 2352
lV , 19�_
Pursuant to written applicatior, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at_6 (Ll-rC'/( l�y�
on the
side, between
at premises owned by �L-4Lddj-yL , t2la9&6 �
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
l#lq,o�
Signed
Connection Charge Paid$ Licens Min- err
Issued by
,,Tax Collect r
G' Permit Fee: Paid $ _Sf 0d
INSPECTION: Check Number: l(0�
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
(Sig)
INSPECTOR
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i
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�ctFP /ly�C11,E�E�, t �
ml I
17
NOTES SOUTH WINDSOR POLLUTION CONTROL
LOCATION ►- r-
OWNER Me�"I fta
TYPE OF WORK S � Pw 2 r re,
DATE $/PERMIT cP—3 f.--2—PIPE t1
INSTALLER
INSPECTOR S DRAWN BY