HomeMy WebLinkAboutDrain Layers Permit 132 Maskel Road TOWN OF SOUTH WINDSOR
DEPARTMENT OF POLLUTION CONTROL gip No.:
South Windsor, Connecticut
List No.: _ 9Z 7 �.
DRAIN LAYER'S PERMIT ND 1883
Pursuant to written applicatior, permission 's hereby granted to the Licensed Drain Layer named herein to perform
the work indicated bel w at ���� t�t YD. --, on the
side, between
at premises owned by
whose address is
and to Lay House Drain, Repair House Drain, Lay-Main, Other
for
t
'
QtLC i - occupancy or use,
with yU"amily Units, with/ acres.
Type of Sewage to be nected 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
Signed
Connection Charge Paid 4100.O U Licensed Drain Lay r
Issued by
Tax Collector
W�v rj Permit Fee:.Paid $ DO _
INSPECTION: Check Number: a`(/b S-
INITIAL (Sig) C. ve4 4w-�-
FINAL (Sig)
APPROVED 0 Z (Date)
(Sig)
INSPECTOR
N
k � o
a � �
P _
- - - v, 51
0
�r
r
NOTES SOUTH WINDSOR POLLUTION CONTROL
LOCATION
OWNER
TYPE OF WORK
DATE /v A2 A An PERMIT PIPE If
INSTA �.,
INSPECTOR DRAWN BY