HomeMy WebLinkAboutDrain Layers Permit 115 Murielle Drive ` TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL gip No.:
South Windsor, Connecticut
List.No.: _ C�
DRAIN LAYER'S PERMIT Np 1296
Pursuant to written applica or, ermi lion is he b granted to the Incensed Drain Layer named herein to"perform
the work ind' ted low at U /"� t�41`/t "�� t
46V V 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 X INDUSTRIAL gASW
Connection will be made with
d
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
Vol'Signed
Connection Charge Paid " Lic d Drain e
`?2 Issued by
Tax Collector f c
Permit Fee:. Paid $ _ / ✓ i ro
INSPECTION: Check Number: "
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
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- ( r-cez �f (Sig)
INSPECTOR
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NOTES SOUTH WINDSOR POLLUTION CONTROL
LOCATION
OWNER >�i -< `
TYPE OF WURKCD
DATE - - 7 PERMIT 'e 6 PIPE
LLE INST R e
INSPECTOR DRAWN BY
OF
sotrT
H NDS WI o
sOUTH W o o HALE R
R' CONN 06074
DEPART ME1VT ppLLU?'I
ON CONTROL
Date
The Sanita %� • . .ry Sewer
at
septic System
4
or lot �� .?
in accordance with the has ,been Insta
and regulations. T lled°wn of South Wind d o°mpleted
dinances
accepted and Approved
r
�_�� Date