HomeMy WebLinkAboutDrain Layers Permit 201 Norton Lane rL
TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL
B/P No.:
South Windsor, Connecticut List.No.:
DRAIN LAYER'S PERMIT Np 1597
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Pursuant to written applicatior, permission is hereby granted to the Licensed Drain La er named herein to"perform
the work indicated below at on the
e2 �� ��^ cl side, between
at pre ises owned by
whose address is
San/-
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 ( /A)�, INDUSTRIIAL WASTE �.( .), OR ( )
Connection will be made with-
Permit to be issued to
the holder of Drain Layer's License No.,.,f-.A 7 0 ��_, Permit will expire on I
The undersigned Drain Layer hereby agrees to all the terms and conditions set forth on the permit and the reverse sidef
thereof. Applicant has received Town Permit No. and/or C H D Permit No.
for street excavation.
SPECIAL CONDITIONS
r
c(� Signed �
Connection Charge Paid T. 0 Q License�D,,inl-,
13
4carzZI
Issued by
T x C hector y►
Permit Fee: Paid $
INSPECTION: Check Number: 2
INITIAL (Sig)
FINAL (Sig)
APPROVED 7 2 (Date)
INSPECTOR (Sig)
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NOTES SOUTH WINDSOR POLLUTION CONTROL
LOCATION 7- ,S
OWNER
TYPE OF WOAK
DATE s PERMIT PIPE
INSTALLE
INSPECTO DRAWN BY