HomeMy WebLinkAboutDrain Layers Permit 123 Murielle Drive TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL
B/P No.:
South Windsor, Connecticut Z
List.No.:
DRAIN LAYER'S PERMIT rjo 1295
f- 1S , 19
Pursuant to written appli atigr permission hereby gra ted to the Licensed Drain Layer named herein to perform
the work indicate below at 0[, the
a� 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 (/Q, INDUSTRIA W S ), OR ( )
a
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
Connection Charge Plaid y Lice Drain e
Issued by
Tax Cod ector
Permit Fee:. Paid $
INSPECTION: Check Number: Z 6
INITIAL (Sig)
FINAL ll (Sig)
APPROVED /ffd ) (Date)
INSPECTOR (Sig)
3
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NOTES SOUTH WIND OR POLLUTION CONTROL
LOCATION / ari• 6 e7777S3
OWNER
TYPE OF WOP& A441PfQrVn,
DATE y- PERMIT 1 PIPE
INSTALLER
INSPECTOR CI--7 DRAWN BY �-
TOWN OF SOUTH WINDSOR
TOWN HALL
SOUTH WINDSOR, CONN. 06074
DEPARTMENT POLLUTION CONTROL
Date . , . " 2
The Sanitary Sewer x . . . Septic System . . . . . . . . . .
or lot #. . . . ' . has been installed and completed
in accordance with the Town of South Windsor ordinances
and regulations.
Aaepte4 1 Approved
Date