HomeMy WebLinkAboutDrain Layers Permit 351 Oakland Road TOWN OF SOUtH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL B/P No.:
South Windsor, Connecticut .��Os.•�..i
List No.:
DRAIN LAYER'S PERMIT Na 619
&IX 'its , 19 74
Pursuant to written applicatior, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at 7-" (WW TV* on the
amt side, between !'-rrZrf- i- rr;l t eka.
at premises owned'by- is --ha law f np,14$
whose address is }�
and to )t Lay House Drain, Repair House Drain, Lay Main, Other ,
for occupancy or use,
with 02* Family Units, with acres.
Type. of Sewage to be connected under this permit:
SANITARY SEWAGE (X ), INDUSTRIAL WASTES ( ), OR ( )
Connection will be made with t�� �` 1' � pi"
Permit to be issued to Axth= D
_
the holder of Drain Layer's License No. ""20998~n' Permit will expire on }o 10 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
Signed `.,-
Connection Charge Paid ` J Licensed Whin Lyxye�
terq & mealsIssued by Intl 't .A, P;•'� `'i�dt?"?�3'�«k 4x'i
Tax Collector
Permit Fee: Paid $ A*tErTl
INSPECTION: Check Number:
INITIAL (Sig)
FINAL Y (Sig)
- '
APPROVED c ' (Date)
;,/ INSPECTOR (Sig)
y f.
M ' ~
V
/S
7 r
NOTES SOUTH WINDSOR POLLUTION CONTROL
LOCATION SJ7
OWNER rci
TYPE OF WORK Jew"-
DATE iv PERMIT ,g PIPE
INSTALLER i)44
INSPECTOR DRAWN BY daf