HomeMy WebLinkAboutDrain Layers Permit 393 Nevers Road TOWN OF SOUTH WI N DSOR
r DEPARTMENT OF POLLUTION CONTROL Bhp No.:
South Windsor, Connecticut
List No.:
DRAIN LAYER'.S PERMIT N? 2271
3 P 19 y
Pursuant to written applicatior, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at 1 3 ✓//t°//f%S /Y�
on the
side, betw`eeeen
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 (VII, 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
4
b
r/ Signed
Connection Charge Paid Licensed Drain Layer
A-
Issued by
C �
4/ Tax Collector
UU
Permit Fee: Paid $
INSPECTION: Check Number: S U �
INITIAL (Sig) Iv/fi?l /uus
FINAL (Sig)
APPROVED / (Date)
(Sig)
PECTOR
fV ,,
1
i
a
N� t> a r
NOTES SOUTH WINDSOR POLLUTION CONTROL
LOCATION -5 e- vp.. ►
OWNER z n S �,
TYPE OF WORK
DATE 7-11 P RMIT,22,71 PIPE
INSTALLER 't . 4
INSPECTOR c- DRAWN BY -