HomeMy WebLinkAboutDrain Layers Permit 35 Mohegan Trail TOWN OFF 36'JTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL B/P No.:
South Windsor, Connecticut
List.No.: _
DRAIN LAYER' S PERMIT N? 607
Pursuant to written applicatior, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at t":`t 4 46 I� Corp* -35 644�4 ( 1,e414J on the
zerft 16 side, between rollk lit, 't, C!w1„k�Qg
at premises owned by MR Ehas , IS Copp
whose address is 99 000ter at,
and to ' Lay House Drain, Repair House Drain, Lay Main, Other ,
for A**tAy1
occupancy or use,
with Family Units, with acres.
Type of Sewage to be connected under this permit:
SANITARY SEWAGE ( X), INDUSTRIAL WASTES ( ), OR ( )
Connection will be made with Oil (46) 11M-h Plaistieo :!;41111
Permit to be issued to JX, Spumer
the holder of Drain Layer's License No. V%!2M!" Permit will expire on . 19
The undersigned Drain Layer hereby agrees to all the terms and conditions set forth on the permit'aM 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 Licensed Drain Layer`
Per# a. Hati E Issued by 2*7 , s
Tax Collector
Permit Fee: Paid
INSPECTION: Check Number:
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
(Sig)
INSPECTOR
N
NOTES SOUTH WINDSOR POLLUTION CONTROL
LOCATION
OWNER isi:v c�ir-
TYPE OF WORK
DATE e, ,2 zvPERMIT -,1'01 PIPE
INSTALLER
INSPECTOR Jr' DRAWN BY a