HomeMy WebLinkAboutDrain Layers Permit 240 Northview Drive TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL
South Windsor, Connecticut B/P No.:
List No.: _
DRAIN LAYER' S PERMIT No 598
'tr• 21 19 •'1
Pursuant to written applicatior, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at ' e-i" ' 411or UU`yIee,w 7.)z' $7 � on the
': eat side, between : i..;'IES '.t[. nl-s.v
at premises owned by
whose address is
and to Lay House Drain, Repair House Drain, Lay Main, Other
for �^ ^n.t.—In
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 sz>, `i' i Aci',
Permit to be issued to
the holder of Drain Layer's License No. `'`�"`'t1i� F'+`� Permit will expire on ' '• <'1 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 �.f %�` Licensed Drain Layer
Jr.
Issued by
Tax Collector
Permit Fee: Paid $
INSPECTION: Check Number: _
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
INSPECTOR (Sig)
N
Off-j 6p
NOTES SOUTH WINDSOR POLLUTION CONTROL
LOCATION rr W o i !/i�lr✓
OWNER - A
TYPE OF WORK
DATE / < PERMIT PIPE
INST ,1v
INSPECTOR WN BY