HomeMy WebLinkAboutDrain Layers Permit 98 Old Farm Road TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL B/P No.:
South Windsor, Connecticut
List No.: _ —�-
DRAIN LAYER'S PERMIT NO 2297
1 C 19 do/
Pursuant to written appliratior, permiss'on is hereby granted to the Licensed Drain ayer named herein to perform
the work indicated below at on the
side, betty en
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 ( : j; 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/br C H D Permit No.
for street excavation.
SPECIAL CONDITIONS
Sig
Con] ection Charge Paid Licensed Drain Layer
r
Issued by
Tax Collector � /�,�
Permit Fee: Paid $ _16GG,D0
INSPECTION• Check Number:' a
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
(Sig)
INSPECTOR
N
NOTES SOUTH WINDSOR POLLUTION CONTROL ,
LOCATION o O a ✓hr S
OWNER S o r .Q.- S aZe--s
TYPE OF WORK S 41; lfar w ram' r
DATE 3-1�13- ! PERMIT 'i '�`T PIPE "p V C—
INSTALLER r,e h C a n s ,
INSPECTOR S - C- DRAWN BY