HomeMy WebLinkAboutDrain Layers Permit 344 Nevers Road r TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL
_. B/P No.:
South Windsor, Connecticut
List No.: =T )
DRAIN LAYER'S PERMIT N? 673
mod. 00t.5.4974 , 19
Pursuant to written applicatior, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below ate+r.T Us"ra Uaacli on the
side, between
at premises owned by__ W14. J. Nonnrre t
whose address is jWWw
and to XLay House Drain, Repair House Drain, Lay Main, Other
for Has—d—dimU.&I occupancy or use,
with LCA Family Units, with acres.
Type of Sewage to be connected under this permit:
SANITARY SEWAGE ( 7), INDUSTRIAL WASTES ( ), OR
Connection will be made with Six Ioah k1jantic Pima
Permit to be issued to Ad= Wiftiew
the holder of Drain Layer's License No. W-9 2065 Permit will expire on 1Z,�r4 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 Licensed Drain Layer
Issued by FrF * J' smith
Tax Collector
Permit Fee: Paid $
•si
INSPECTION: Check Number:
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
(Sig)
INSPECTOR
NOTES SOUTH WINDSOR POLLUTION CONTROL
LOCATION
OWNER
TYPE OF WORK
DATE PERMIT PIPE
INSTALLER
INSPECTOR DRAWN BY