HomeMy WebLinkAboutDrain Layers Permit 357 Nevers Road TOWN OF SOUTH WINDSOR
DEPARTMENT OF POLLUTION CONTROL
B/P No.:
South Windsor, Connecticut
List No.: �7 7
DRAIN LAYER ' S PERMIT NO 1899
l � 19 j
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Pursuant to written applicatior, permission is hereby granted to the Licensed Drain Layer named herein to perform
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the work indicated below at iZ /'1''"'s _ ��'-'' on the
side, between
at premises owned by—
whose address is 5 Al
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 ( ); 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
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# C� j"�/�/�� 00 SigneddW7,":1,,/
Connection Charge Paid (/r` -Licensed Dr in Layer
Ir
Issued by ! l j
Collector `
Permit Fee: Paid $
INSPECTION: Check Number:
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
(Sig)
INSPECTOR
N
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NOTES SOUTH WINDSOR POLLUTION CONTROL
LOCATION
OWNER
TYPE OF WORK
DATE fn- � �- PERMIT PIPE t
INSTALLER
INSPECTOR DRAWN BY