HomeMy WebLinkAboutDrain Layers Permit 22 Murielle Drive TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL B/P No.:
South Windsor, Connecticut �,Z 2
List.No.: _
DRAIN LAYER',S PERMIT N? 1274
19
Pursuant to written apphc ior, permissiongeby granted to the icensed Drain Layer named herein to perform
the work i icate below at 3 3 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 (\J., INDUS L WASTES
.( , OR ( )
Connection will be made witht�
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 U Permit No.
for street excavation.
SPECIAL CONDITIONS
Signed
Connection Char Paid m Licensed Drain Layer
Issued by
Tax Collector
Permit Fee:. Paid $ _ _ ��
INSPECTION: Check Number:
INITIAL (Sig)
FINAL (Sig)
APPROVED " l-7 (Date)
t^C (Sig)
INSPECTOR
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NOTES SOUTH WINDSOR POLLUTION CONTROL
LOCATION 3 orf elk 22
OWNER G 4 e
TYPE OF WO U
DATE - PERMIT/�? PIPE
INSTALLER
INSPECTOR ECDRAWN BY
a
TOWN OF SOUTH WINDSOR
TOWN HALL
SOUTH WINDSOR, cONN. 06074
DEPARTMENT POLLUTION CONTROL
Dat
e /. . . . .,1 . . . . . . . . .
The Sanitary Sewer . . . •
Septic System ... . . . . . . . .
at . . ': . . . . . . . . . . . . .
or lot #. . . . • • • has been installed and completed
in accordance. with the Town of South Windsor ordinances
and regulations.
Accepted and Approved _
f 'r: Date — ——�
yr �.