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TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL
B/P No.:
South Windsor, Connecticut S61o4�
List.No.: _
DRAIN LAYER'S PERMIT 1070
22 n=ri l , 19 76
Pursuant to written applicatior, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at -136 Mahe can TrAi_l (Lot 39) on the
side, between
at premises owned by TTPIR
whose address is
and to X ' Lay House Drain, Repair House Drain, Lay Main, Other
for residential
occupancy or use,
with one (1) Family Units, with acres.
Type of Sewage to be connected under this permit:
SANITARY SEWAGE iKX), INDUSTRIAL WASTES 0R ( )
Connection will be made with six-inch .(611) plastic.i c pil2c
Permit to be,issued to. . James L. Belay
ay
the holder of Drain Layer's Licepse.No.. ...W9-205793 Permit will expire on 22 June 19�
The undersigned Drain Layer heye§y 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 02-1 B-76 Licensed Drain Layer
Rec. 929 Issued by Melvin Edwards, Jr.
Tag Collector
Permit Fee:. Paid $ _ 15.00
INSPECTION: Check Number: 525
INITIAL /o 2 2
FINAL (Sig)
APPROVED?-2 M,4j 076 (Date)
`0
4J.-.42, a. . . (Sig)
INOPCTOR
N
0�10
NOTES SOUTH WINDSOR POLLUTION CONTROL
Drawing not to scale. LOCATION 136 Mohe an Trail (Lot )
OWNER
TYPE OF WORK House Connection
DATE PERMIT 1070 PIPE
INSTALLER Beley W9-205793
INSPECTOR DRAWN BY
TOWN OF SOUTH WINDSOR
TOWN HALL
' SOUTH WINDSOR, CONN. 06074
DEPARTMENT POLLUTION CONTROL
.3
Date . . .'2 >pri1, 1a76. . . . . . .
The Sanitary Sewer . . . . . . . Septic System . . . . . . ._.
ato�E6,a.t Ti. . . . . . . . .
or lot #. . . ;�9. . . . . . has been installed and. completed
in accordance with the,Town of-South Windsor ordinances
and regulations.
Accepted and Approved
ward . Jr. 4By Y 19
Sanitary Inspector