HomeMy WebLinkAboutDrain Layers Permit 81 Norton Lane (2) TOWN `OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL
B/P No.:
Li
South Windsor, Connecticut ;p
st.No.: _-
DRAIN LAYER"S PERMIT NO 2005
19
Pursuant to written applicatior, permission is hereby granted to he Licensed Drain Layer named herein to perform
the work indicated below at / z/ & & on the
H
side, between
f
at premises-owned by4
whose address is
and to Lay House Drain, Repair House Drain, Lay Main, Other
for �� ' occupancy or use,
with 4=1Family Units, with acres.
Type of Sewage to be connected under this permit:
SANITARY SEWAGE ( ee).1,101'N1DUSTRI4LL WASTES OR ( )
t
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 �.a J &L�rzez
Signed e4
Connection Charge Paid 10� U 0 Licensed Drain Layer
Issued by
Tax Collector
coos— 04
Permit Fee:. Paid /�
INSPECTION: Check NumberL
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
INSPECTOR (Sig)
�1
i
j
NOTES_ SOUTH WINDSOR POLLUTION CONTROL
LOCATION e)
OWNER
TYPE OF WORK
DATE D PERMIT Z OD PIP
INSTA R A
INSFECTqR9 DRAWN BY