HomeMy WebLinkAboutDrain Layers Permit 125 Norton Lane TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL B/P No.:
South Windsor, Connecticut �3
List.No.: _
DRAIN LAYER'S PERMIT Np 1403
U►J , 19 78
Pursuant to written applicatior, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at 195 M O RTD IA i-A-NE L L 8-L *0 3> on the
side, between
at premises owned by—
whose
address 's
and to Lay House Drain, Repair House Drain, Lay Main, Other
for ZE.S'/�,j/ L_ occupancy or use,
with Q/(12 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—. �lck--,
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 an 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 c7�7, Licensed Drain Layer
Issued by
-Tax Collector
Permit Fee:. Paid $
INSPECTION: Check Number:
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
(Sig)
IN9WCTOR
N
NOTES SOUTH WINDSOR POLLUTION CONTROL
LOCATION N dRToN LA4c L OT 44-
OWNER 7TM
TYPE OF WORK kus�. Qo ouNsc-(1 0M
DATE PERMIT Ht3 PIPE " PVC,INSTALLER s k ,
INSPECTOR DRAWN BY (�!�