HomeMy WebLinkAboutDrain Layers Permit 10 Pine Knob CirclePrTOWN OF , OU.TH WINDSOR
DEPARTMENT OF POLLUTION CONTROL Bhp No.: 21—.tr
South Windsor, Connecticut
List No.: -r-6421
DRAIN LAYER'S PERMIT O 513
Doc e 3 19 73
Pursuant to written applicatior, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at 10 Pia* kitob Ciro (1107 on the
W*st side, between Pin* Saab & Ctl..d* met
at premises owned by1Pab1111
whose address is awe
and to x Lay House Drain, Repair House Drain, Lay Main, Other
for residential occupancy or use,
with one Family Units, with acres.
Type of Sewage to be connected under this permit:
SANITARY SEWAGE F ), INDUSTRIAL WASTES ( ), OR ( )
Connection will be made with AiX inoh (6) plastic jgk."
Permit to be issued to John LmaoA
the holder of Drain Layer's License NO.W9-206188 Permit will expire on Feb ig 3 1
The undersigned Drain Layer hereby agrees to all the terms and conditions set forth on the permit and the reverse Zde
thereof. Applicant has received Town Permit No. and/or C H D Permit No.
for street excavation.
SPECIAL CONDITIONS" UT9r 10 PMP* 0VU4b and baakfi l ant jot tmuir
Signed
Connection Charge Paidl2/"3 Licensed Drain Layer
Par* E. Moniz 9 426 Issued by nth Ae St&rkW*ath*r Jre
Tax Collector
Permit Fee: Paid $15*00
INSPECTION: Check Number: 1317
INITIAL (Sig)
FINAL �/ /� ` /ll:: :; �� -(Sig)
APPROVED (Date)
---- __
(Sig)
INSPECTOR
N
D
NOTES SOUTH WINDSOR POLLUTION CONTROL
LOCATION o x;yv cie
OWNER �t A/ aZ c
TYPE OF WORK L4z
DATE 2 PERMIT S /-? PIPE
INSTALLER
INSPECTOR f DRAWN BY ✓