HomeMy WebLinkAboutDrain Layers Permit 41 Murielle Drive TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL gip No.:
South Windsor, Connecticut 0 /
List No.: _
DRAIN LAYER'S PERMIT
0 1247
197
7-
Pursuant to written applic for permission is her by grante to the Licensed Drain Layer named herein to perform
the work indicated below at 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 (\/o!� INDUSTRIAL WASTES .( ), OR ( )
Connection will be madg,: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 '000/
/0 Connection Charge Paid ensed Drain Layerol
Issued by
Tax Collector
Permit Fee:. Paid $ _ �x" 0 b
INSPECTION: Check Number: . �/9
INITIAL (Sig)
FINAL (Sig)
APPROVED ' Z �' (Date)
(Sig)
1 INSPECTOR
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N Aor
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NOTES SOUTH WINDSOR POLLUTION CONTROL
LOCATION 27 1 fo i z ;C -
OWNER = C/ allill
TYPE OF WORK
DATE e-2-7Z PERMIT PIPE
. INSTALLER'
INSPECTOR - -/ DRAWN BY `~
TOWN OF SOUTH WINDSOR
TOWN HALL
.SOUTH WINDSOR, CONN. 06074
DEPARTMENT POLLUTION CONTROL
Date . . .v`0. . . . . . . . . . .
The Sanitary Sewer . . . . . Septic System P Y . . . .
*41
.. . . . . . . . . . . . . . . . . . . ... . . . . . . . . . . . .
or lot #. • • • •-77. . . . . . has been installed and completed
in accordance with the Town of South Windsor ordinances
and regulations.
Accepte'a d "Approved
Date