HomeMy WebLinkAboutDrain Layers Permit 39 Old Farm Road TOWN OF SOUTH WINDSOR
DEPARTMENT OF POLLUTION CONTROL B/P No.:
South Windsor, Connecticut List No.: _
DRAIN LAYER'S PERMIT N? 1885
19
Pursuant to written applicatior, permission ' hereby, granted to;the L'censed Drain Layer named herein to perform
the work indicated below at ! on the
side, between
at Y remises owned b �l�
P
whose address is
and to Lay House Drain, Repair House Drain, Lay-Maim, Other
for occupancy or use,
with Family Units, with acres.
Type of Sewage to be connected under this permit:
SANITARY SEWAGE (Y), INDUSTRIAL WASTES .( ), OR ( )
Connection will be made with
Permit to be issued to '7-zr O�i,
the holder of Drain Layer's License No. WV 106 0 Permit will expire on 19�y
The undersigned Drain Layer hereby agrees to all the terms aqd 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
)0/11 7f
�c1o� `��/� Signer• %w2't.- --,✓�' [•��-
Connect�on Charge Paid 0.0 a Licensed Drain Layer
/Vo I
Issued by
Tax Collector 10 1117f I
Permit Fee: Paid $ i5`00
INSPECTION: Check Number:
INITIAL (Sig) �p/ �y 6�d rvr� 14
FINAL (Sig)
APPROVED O (Date)
(Sig)
INSPEC R
r�
N
_ LvTST
a %
NOTES SOUTH WINDSOR POLLUTION CONTROL
LOCATION
OWNER
TYPE OF WORK
DATE D PERMIT PIPE
INSTALLER
INSPECTOR,g& RAWN BY �i 6P,,&