HomeMy WebLinkAboutDrain Layers Permit 6 Palmer Drive - TOWN OF SOUTH,* WINDSOR
DEPARTMENT OF POLLUTION CONTROL B/P No.:
South Windsor, Connecticut
List No.: — u
4) DRAIN LAYER'S PERMIT NO 626
17 MY
, 19 '4
Pursuant to written appllicatior, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at iR A&M VA" (114 on the
# side, 000W It 211111110 ftbe ifs
at premises owned by
whose address is one
and to X Lay House Drain, Repair House Drain, Lay Main, Other ,
for occupancy or use,
with me 0) Family Units„with acres.
Type of Sewage to be connected under this permit:
SANITARY SEWAGE 0), INDUSTRIAL WASTES ( ), OR
Connection will be made with ,43050 114914" 911 * S 1^4601 Was as 4ft J4430
Permit to be issued toJeft Aq &OWN RIM
the holder of Drain Layer's License No. "-A" Permit will expire on 17 4"Wom 19�R
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
f
y Signed �• yr..
Connection Charge Paid Licensed Drain Layer
Aw
Issued by V" 3101000ft# 40
Tax Collector
Permit Fee: Paid $ _I
SM
INSPECTION: Check Number:
INITIAL 0/47 0 ' (Sig)
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FINAL 07^7 r I.M.1 (Sig)
APPROVED-17 JWWO S 11 (Date)
(Sig)
INSPECTOR
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NOTES SOUTH WINDSOR POLLUTION CONTROL
Scale: 1" - 40' approx. LOCATION 6 Palmer Drive (Lot 88)
OWNER Robert R. Straxdber
A 08.3 ft TYPE OF WORK House Coxxeetiex
B 16.5 ft DATE 4 PERMIT 626 PIPE6" Plast.
INSTALLERLamsox-(W9-206188)
INSPECTOR ME DRAWN BY ME
'bwa. 14- G