HomeMy WebLinkAboutDrain Layers Permit 442 Oakland Road TOWN OF SOUTH WI N DSOR
r DEPARTMENT OF POLLUTION CONTROL
n� South Windsor, Connecticut B/P No.: 5J2
List No.: a
IV,; DRAIN LAYER'S PERMIT O
2177
, 19
Pursuant to written applirc/a`t�ior, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at 7 ( Z— 6az&-1,y W 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 Family Units, with acres.
Type of Sewage to be connected under this permit:
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 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 Ch Paid Lr— lcensed Drain ayer
Issued by
T Collector >
Permit Fee:. paid $(��__
INSPECTION: Check Number: _ CZ—
INITIAL (Sig)
FINAL (Sig)
APPROVED _ (Date)
r
INSPECTOR (Sig)
NIX
41
tT
4
NOTES SOUTH WINDSOR POLLUT ON CONTROL
LOCATION a- 0,7FL "`
OWNER
TYPE OF WORK s s
DATE F ;it Su PERMIT 1 I I PIPE G " v
INSTALLER 4ulls, '
INSPECTOR 5 DRAWN BY