HomeMy WebLinkAboutDrain Layers Permit 104 Norton Lane TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL
B/P No.:
South Windsor, Connecticut 6i33D
List.No.: _
DRAIN LAYER'S PERMIT Np 1405
19 �8
Pursuant to written applicatior, permission is hereby granted to the Licensed Drain Layer named herein to.perform
the work indicated below at- 104 /20474A) 44A,24-- /2e.4- on the
7
side, between
.^
at premises owned by_�/ /�
whose address is
and to V Lay House Drain, Repair House Drain, Lay Main, Other
for , fS/D 6-/1/'T"/A L— occupancy or use,
with - B[I/ 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 DrainLayer 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
-- (s — �� �� Issued by2A�j
Tax Collector
Permit Fee:. Paid $
INSPECTION: Check Number:
INITIAL (Sig)
FINAL (Sig)
APPROVED - 7 (Date)
(Sig)
SPECTOR .
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NOTES SOUTH WINDSOR POLLUTION CONTROL
LOCATION Oat 4
OWNER !' 1
TYPE OF WORK Ha7l5G CoNvcc--o°iV
DATE PERMIT =C,5r PIPE llpvcl
INSTALLER 9ex Cons uc 'a�
INSPECTOR DRAWN BY