HomeMy WebLinkAboutDrain Layers Permit 192 Oak Street K-�
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NOTES SOUTH WINDSOR POLLUTION CONTROL
LOCATION 9 2 Oa
OWNER
TYPE OF WORK
DATE .2 7 PERMIT PIPE "PVC_
INSTALLER W. /►1� ,'NNE
INSPECTOR DRAWN BY
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TOWN OF SOUTH WINDSOR ` ..
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r DEPARTMENT OF POLLUTION CONTROL
South Windsor, Connecticut
F '.r . DRAIN LAYER'S PERMIT N° 304
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19
Pursuant to written application, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at t L6T- on the
side, between
at premises owned by
whose address is
and to Lay House Drain, Repair House Drain, Lay Main, Other
for occupancy or use,
with n. Family Units, with acres.
Type of Sewage to be connected under this permit:
i`SANITARY SEWAGE, INDUSTRIAL WASTES, OR
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 p*Tthe reverse side
thereof. Applicant has received Town Permit No. and/or C H D Permit No.
for street excavation.
SPECIAL CONDITIONS }
Signed <4'�
Connection Charge Paid $ 1 c. Licensed Draid Layer
t .x (Sig) issued bye"., �
Tax Collector
Permit Fee: Paid $
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INSPECTION: } � Z
INITIAL (Sig)
FINAL (Sig)
APPROVED Zq--•�t "' _!4""� (Date)
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Of (Sig)
/ IN P CTOR