HomeMy WebLinkAboutDrain Layers Permit 210 Norton Lane TOWN OF SOUTH WINDSOR
DEPARTMENT OF POLLUTION CONTROL B/P No.:
Li
South Windsor, Connecticut st No.: ( 59 E
_
DRAIN LAYER'S PERMIT N? 1636
19 ? 7
Pursuant to written applicatior, permission is hereby granted to the Licensed rain Layer named herein to perform
1
the work indicated below at 6 on the
side, between
at premises owned by
whose address is V
and to Lay House Drain, Repair House Drain, Lay-Main, Other—
for ,
� � — / occupancy or use,
with 4tdzyamily Units, with � — acres.
Type of Sewage to bbee onnected under this permit:
SANITARY SEWAGE (/��, INDUSTRIAL WASTES .( ), OR ( )
Connection will be made with
Permit to be issued to
the holder of Drain r 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
Signed
Connection Charge Paid S'—2. Licensed Drain Layer
3jLL
/ Issued by
Tax Collector
Permit Fee:r Paid $
INSPECTION: Check Number:
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
(Sig)
SPECTOR
N
y �
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M N
4L
bJ s9
x
m
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NOTES SOUTH WINDSOR POLLUTION CONTRJQL
LOCATION
OWNER
TYPE OF 14ORK �r
DATE PERMIT PIPE t44
INSTALLER 00,
INSPECTOR RAWN BY