HomeMy WebLinkAboutDrain Layers Permit 155 Norton Lane TOWN OF SOUTH WINDSOR
DEPARTMENT OF POLLUTION CONTROL B/P No.:
South Windsor, Connecticut . 03
List.No.: _
DRAIN LAYER'S PERMIT Np 1470
19 _
Pursuant to written applicatior, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at. LVOR-rb l ZAAAr- Lof on the
side, between
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 (gG}, 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
/L Signed
Connection Charge Paid 79 Licensed Drain Layer
Issued by "o tD
Tax Collector
Permit Fee: Paid $
INSPECTION: Check Number:
INITIAL (Sig)
FINAL 2 (Sig)
APPROVED (Date)
(Sig)
INSPECTOR
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1 Y�
N
E.p. 6.5 '
C
15.3
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NOTES
SOUTH WINDSOR POLLUTION CONTROL
LOCATION 1_.o r
OWNER w
TYPE OF WORK you e. Conner jo n
DATE -3-1 PERMIT I '70 PIPE " PVC,
INSTALLER .4-
INSPECTOR ,%. DRAWN BY C.K.