HomeMy WebLinkAboutDrain Layers Permit 51 Pine Knob Drive TOWN OF SOU. VI N DSOR
DEPARTMENT OF P. U ION CONTROL ,
x t South Windsor n ecticut
DRAIN 'LAYER'$ •PERMIT 251
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t
Pursuant.to written application, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at -e j `t ,oWMU Ato40t on the
r -- - side, between
at premises owned bye
r whose address is 4
' and to` Lay House Drain, Repair House Drain, Lay Main, Other ,
r for .,,ia'a :>� �- :. r1
occupancy or use,
with Family-Units, with acres.
` ;Type of Sewage to'be connected under this permit:
SANITARY SEWIGE, I1�DU REAL WASTES OR
Connection will be made with40
F,
Permit to be issued to. A. X
the holder of Drain L"ayer's License No. Permit will expire;on
The undersigned Drain Layer hereby agrees to all the terms and conditions set forth on the piftmi d I~id;k e r e si
•
thereof. Applicant has received Town,Permit No. and/or C H D Permit No.:
for street excavation, +.
ti SPECIAL CONDITIONS : -- •=� f ��+"�$ =# 8a
f.: > t^ .t
Signed
Connection Charge Paid' ' Lir� Drao2 Li
m,
(Sig) Issued by -- A '�
Tax Collector
Permit Fee: Paid
INSPECTION: f' AV `
INITIAL
FINAL (Sig)
APPROVED (Date)
�5 s (Sig)
r
N
d
04
,pd
l
NOTES SOUTH WINDSOR POLLUTION CONTROL
LOCATION 6
OWNER
TYPE OF WORK
DATE PERMIT PIPE
INSTALLER
INSPECTOR DRAWN BY