HomeMy WebLinkAboutDrain Layers Permit 200 Orchard Hill Dri TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL
_
South Windsor, Connecticut B/P No.:
List No.: S"eoln&13
DRAIN LAYER'S PERMIT N? 767
Dtc. 15. 74 , 19
Pursuant to written application, permission is hereby granted to the Licensed Drain Layer named herein to perform
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the work indicated below atLOt (9) Orchrid Hill Drive on the
side, between
at premises owned by ViuQr Ce��t
whose address is
and to X Lay House Drain Repair House Drain Lay Main, Other
for Residential
occupancy or use,
with Ote Family Units, with acres.
Type of Sewage to be connected under this permit:
SANITARY SEWAGE (X), INDUSTRIAL WASTES ( ), OR
Connection will be made with Six IAch Plastic Pipe
Permit to be issued to Robert L. Davix
the holder of Drain Layer's License No. W-9M935 Permit will expire on 1Z15/75 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 ;:_ ..:."• e
Connection Charge Paid License Drain Layer
Issued by Frank J. Smith
Tax Collector '
Permit Fee: Paid $ 15.00_
INSPECTION: Check Number:
INITIAL f j* , (Sig)
FINAL f jo ,f (Sig)
APPROVED fjo
J' '+ (Date)
(Sig)
"INSPECTOR
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NOTES SOUTH WINDSOR POLLUTION CONTROL
LOCATION
OWNER
TYPE OF WO
DATE PERMIT PIPE
INSTALLER
INSPECTOR DRAWN BY