HomeMy WebLinkAboutDrain Layers Permit 5 Oakland Road TOWN OF . SOUTH# WINDSOR
DEPARTMENT OF P*.+-UT4ON CONTROL
South Windsor, Connecticut / 7
DRAIN LAYER'S PERMIT N? 464
Pursuant to written application, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at V OAKS" no. on the
side, between_ + 41
at premises owned by *
whose address is Oft
and to Lay House Drain, Repair House Drain, Lay Main, Other
for occupancy or use,
with 0 Family Units, with acres.
Type of Sewage to be connected under this permit:
SANITARY SEWAGE) INDUSTRIAL WASTES, OR
-Connection will be made with_ i tli+iwr`
Permit to be issued to '
the holder of Drain Layer's License No.011411111mh Permit will expire on�rml 19
The undersigned Drain Layer hereby agrees to al the terms and conditions set forth on the peit and the reverse s
thereof. Applicant has received Town Permit No. and/or C H D Permit No.
for street excavation.
SPECIAL CONDITIONS
l: f.
Signed_ _ A._ j
Connection Charge Paid $ Licensed Drain. ayes
(Sig) Issued by A* It ifIY►
Tax Collector
Perm' Fee: Paid $
INSPECTION: f
INITIAL ;) 4J {j 72 (Sig)
FINAL // : 0 / f (Sig)
APPROVED 7 (Date)
f ,
(Sig)
INSPECTOR
0
v
N
v-.
A
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NOTES iSOUTH WINDSOR POLLUTION CONTROL
LOCATION .r 0AI,�4.,Iw Si
U OWNER
TYPE OF WORK
DATE !, PERMIT C< PIPE l i r
INSTA LE a
INSPECTOR DRAWN BY Pr