HomeMy WebLinkAboutDrain Layers Permit 161 Maskel Road TOWN OF SOUTH WINDSOR
DEPARTMENT OF POLLUTION CONTROL B/P No.:
South Windsor, Connecticut
List.No.: _�.L ✓�
DRAIN LAYER'S PERMIT N? - 1878
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Pursuant to written applicatior, permission is hereby gra red o the Lice sed Drain Layer named herein to perform
the work indicated below at
�t-� on the
side, between
at premises owned by
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. y
SPECIAL CONDITIONS fir
Re c e,,n�- zzl,y-y
.-#'/ Signed
Connection Charge Paid qoo, OC? 7 Licensed Drain Layer
Issued by
Tax Collector e A, la ,
7y
Permit Fee: Paid $ _ 451 On I�U&V
INSPECTION: Check Number: tly("��?
INITIAL (Sig) /
FINAL (Sig) �R'ii►G� ,p /9m�iyz, j 4.1f
APPROVED d (Date)
(Sig)
INSPECTOR
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NOTES SOUTH WINDSOR POLLUTION CONTROL
LOCATION /
OWNER
TYPE OF WORK
DATE PERMIT IR 7 if PIPE Ai
INSTA '
INSPECTO DRAWN B