HomeMy WebLinkAboutDrain Layers Permit 242 Oak Street TOWN OF S6UTH WI NDSOR
DEPARTMENT OF POLLUTION CONTROL
South Windsor, Connecticut `
List No.: •� � 1
DRAIN LAYER'$ PERMIT
59,6
s
�9 119
Pursuant to written applicatior, permission is hereby granted to the Licensed Drain Layer named herein to perform"`
the work indicated below at 242 0* s""t (to
on the
side, between " D►VO Is 9M DAB"
at premises owned
- whose address is saw
and to X Lay House Drain, - Repair House Drain, Lay Main, Other
for
occupancy or use,
with � +F .: Family Units, with acres.
Type of Sewage to be connected under this permit":
SANITARY_SEWAGE (X ), INDUSTRIAL WASTES _( ), OR
Connection will be made with *Mo to s uuftl inow I
t of 4#.4 i
Permit to be issued to IN s 44A ftUbank OftistrwUm
the holder of Drain Layer's License No. "wW6M Permit will expire on A9#1Wk 19,44
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 � •Q�# Licensed Drain Layer
2~ 0 "9
Issued by v''� 111160*34811 fry
Tax Collector
Permit Fee: Paid $
INSPECTION: Check Number:
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
(Sig)
INSPECTOR
M S
N
NOTES SOUTH WINDSOR POLLUTION CONTROL
LOCATION �T
OWNER
TYPE OF WORKQ.72
DATE --'i ERMIT C PIPE c,
INSTAL
INSPECTOR fr DRAWN BY