HomeMy WebLinkAboutDrain Layers Permit 37 Parkview Drive TOWN OF SOUTH WINDSOR
DEPARTMENT OF POLLUTION CONTROL
B/P No.:
South Windsor, Connecticut
List.No.: .16�-�
DRAIN LAYER'S PERMIT No 1920
�a --2-3 , 192�_
Pursuant to written applicatior, permi -sion is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at 31 on the
side, be een
at premises owned by
whose address is 1t� r ( 1✓L� A
and to Lay House Drain, Repair House Drain, Lay Main, Other
for � �� s
�b occupancy or use,
with Family Units, with A acres.
Type of Sewage to be connected under this permit:
SANITARY SEWAGE ( 111�, INDUSTRIAL WAVTE
( ) ORConnection 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
/61Z V7 7' `=&54)
�/ Signed ;
Connection Charge Paid 1 40• 0O Licensed rain Layer
f% Issued by
Tax Collector
Permit Fee: Paid $ _/-I G
INSPECTION: Check Number:
INITIAL (Sig) �0�0�-►�'1 W[Srl r ec.�tlt.,� �}�`;
FINAL (Sig)
APPROVED — — (Date) 7
(Sig)
INSPECTOR
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NOTES SOUTH WINDSOR PQLLUTION CONTROL
LOCATION E' 1,0
OWNER
TYPE OF WORK 5
DATE/ PERMIT Iq Z.0 PIPE
INSTALLER
INSPECTOR DRAWN BY