HomeMy WebLinkAboutDrain Layers Permit 635 Miller Road TOWW Of SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL
B/P No.:
South Windsor, Connecticut
List No.: I o F - 7
DRAIN LAYER'S PERMIT NO 2067
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Pursuant to written applicatior, permission is hereby granted to he Licensed Drain Layer named herein to perform
the work indicated below at on the
i
side,between
at premises owned by �S a /oO c7/
whose address is
and to Lay House Drain, Repair'House Drain, Lay-&ain, Other
f ,
for ,
-"' �- occupancy or use,.
with 4fW.Family.Units, with acres.
Type of Sewage to be connected under this permit:
SANITARY SEWAGE (•.` ',.,I>\TDUSTRIAL : ASTES ) OR
Connection will be made with
Permit to�bp issued to..
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the holder of Dtain Layer's L}cense.No. € : permit will expire on 19
The undersigned Drain Layer lifeby 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 CQNDITIONS
Signed 2w,,
Connection ChaYge laid` ( U Licensed-Dram Layer
l� / >
f 7 d' :� a l 42` Issued by
Tax Collector
Permit Fee:. Paid S
I_NSPECTION: Check Number: -;7
INITIAL -
(Sig)
FINAL (Sig)
APPROVED
(Date)
INSPECTOR (Sig)
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U
O V
-7
At
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I
NOTES SOUTH WINDSOR POLLUTION CONTROL
LOCATION
OWNER
TYPE OV WORK
DATE - E ITS. PPE
INSTALLS
INSRECTOR DRAWN BY