HomeMy WebLinkAboutDrain Layers Permit 13 Murielle Drive Y TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL Bhp No.:
South Windsor, Connecticut l22
List.No.: _
DRAIN LAYER'S PERMIT 1273
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t -. , 19
Pursuant to written appl'cati r, permission i h reby grantgd to he Licensed Layer named herein to perform
the work in 'cated below at /
on the
Zve 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, 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.
for street excavation.
SPECIAL CONDITIONS
Signed G/ l G ,• f .2 c2 c.
Connection CharKe Paid Licensed Drain Layer
Issued by
Tax Collector
Permit Fee:. Paid $
INSPECTION: Check Number:
INITIAL (Sig)
FINAL (Sig)
APPROVED ` ' (Date)
/ r (Sig)
INSPECTOR
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A
/o / 31
1,3
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NOTES SOUTH WINDSOR POLLUTION CONTROL
LOCATION a�i /` r--
OWNER �ZC3 G
TYPE OF WORK Co are
DATE - - PERMIT 2 -5 PIPE
INSTALLER
INSPECTOR DRAWN BY
TOWN OF SOUTH WINDSOR
TOWN HALL
SOUTH WINDSOR, CONN. 06074
DEPARTMENT POLLUTION CONTROL
r
Date
The Sanitary Sewer . . . Septic System f
.
at
or lot # �. . . has been installed and completed
in accordance with the Town of South Windsor ordinances
and regulations.
Accepted and,Approved
Date
By t �r f/f—
�1
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