HomeMy WebLinkAboutDrain Layers Permit 143 Oakland Road t
TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL '
B/P No:: --
South Windsor, Connecticut
List No.: _
DRAIN LAYER'S PERMIT No 634
19
Pursuant to written applicatior, permissfon is hereby granted to the Licensed.Drain Layer named herein to perform
the work indicated below at on the
side, between MOM
at premises owned by „. �-,.
whose address is
and to �" Lay House Drain, ''Repair House Drain, Lay Main; Other ,
for occupancy or use,
with —Family Units,with acres:
Typ�,:4ofsewage,to_be.connected utlde,r this permit:_ _
SANITARY,SE Ul7AGE
1, INDUSTRIAL WASTES :( ), OR
s Connection will�be made with 4" list *b a
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 stree ,eidWt ation.
SPECIAL CONDI-TIONS
s#c Signed .
Connection Charge Paid ' icensed Drain Layer �.
- _
Rogow 111110
- ' Issued by
Tag Collector
Permit Fee:. Paid $
INSPECTION: ' Check Number:
INITIAL (Sig)
FINAL (Sig)'
APPROVED (Date)
(Sig)
IlVSRECTOR
4 4
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NOTES SOUTH WINDSOR POLLUTION CONTROL
LOCATION 11.3 OAX Ell
OWNER e
TYPE OF WORK
DATE PERMIT 4 PIPE
INSTALIPR-
INSPECTOR DRAWN BY