HomeMy WebLinkAboutDrain Layers Permit 141 McGrath Road • - TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL
B/P No.:
South Windsor, Connes#!-Cut
List No.: _
DRAIN LAYER'S PERMIT NO 2251
i� as , 19 _
Pursuant to written applicatio�r/, permission is h re by granted to the Licensed Drain Layer named herein to perform
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the work indicated below at �� e h �
on the
side, betwee /
at premises owned At re ,1 `
whose address is .
and to Lay House Drain, Repair House Drain, Lay Main, Other
for occupancy or use,
with J 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. `
a
for street excavation..
SPECIAL CONDITIONS
la /1 �
Signed
Connection Charge Paid t164 Licensed Drain Layer
('4 Issued by `
I C Tax Collector
�rm't Nee: Paid $
�a s-/ a
INSPECTION: Check Number: //
INITIAL (Si
t
FINAL (Sig)
APPROVED O (Date)
INSPEC R {Sig)
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NOTES SOUTH WINDS OR POLLUTION .CONTROL
LOCATION i c r i
OWNER fli cal
TYPE OF WORK 2 777
DATE �~\.. ? r�' PERMIT ' �; PIPE v e
INSTALLER
INSPECTOR S C_ DRAWN BY