HomeMy WebLinkAboutDrain Layers Permit 30 Murielle Drive . �• TOWN OF SOUTH WINDSOR
DEPARTMENT OF POLLUTION CONTROL
B/P No.:
South Windsor, Connecticut /lzo Q
List.No.: _
DRAIN LAYER'S PERMIT NO 1246
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19-7z
Pursuant to written appl do , peerrmiss'on is hef gby granted he Li sed Drain Ayer n med herein to perform
the work indicated below at cJ / lU /� v 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 ( INDUSTRIAL W eTlTES R ( )
Connection will be ma e with V
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 Oy Li sed-Drain Layer
Issued by
Tax Collector
Permit Fee:. Paid $
INSPECTION: Check Number:
INITIAL (Sig)
FINAL (Sig)
APPROVED t (Date)
(Sig)
INSPrytTOR
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NOTES_ SOUTH WIND50R POLLUTION CONTROL
LOCATION r
OWNER "
TYPE OF VORK
DATE - PERMIT /Z PIPE
INSTALLER
INSPECTOR - C DRAWN BY =C',