HomeMy WebLinkAboutDrain Layers Permit 146 Pine Knob Drive TOWN OF SOUTH WI N DSOR
c DEPARTMENT OF POLLUTION CONTROL gip No.:
South Windsor, Connecticut
List.No.: _ ` 13 5 1.5
DRAIN LAYER'S PERMIT N? 1407
ullrE 7 19�
Pursuant to written applicatior, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at PIN45 &JVgs .ZQV,5- on the
side, between
at premises owned by-- ALsuwr 04g Nc 7?
whose address is
and to _&ay House Drain, Repair House Drain, - Lay-Main, Other
for occupancy or use,
with Family Units, with acres.
Type of Sewage to be connected under this permit:
SANITARY SEWAGE (W, INDUSTRIAL WASTES .( ), OR ( )
Connection will be made with
Permit to be issued to - )-am sell j,D/Y Z9 r--r/D Al Z AIC',
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
d,6,4 —1�11
Signed
Connection Charge Paid f Licensed Drain Layer
Issued by
Tax Collector
Permit Fee: Paid $
INSPECTION: Check Number:
INITIAL (Sig)
FINAL (Sig)
APPROVED ��� (Date)
(Sig)
SP TOR
N
I
d �
\!s
w
Gle nit
NOTES SOUTH WINDSOR POLLUTION CONTROL
LOCATION /4G f/NE KNc,B O PiV6
OWNER Albert Larne-E.t
TYPE OF WORK Wo u se Cove r ec-}:cs r�
DATE PERMIT 140—) PIPE 6" PVG
INSTALLER LhMSa N
INSPECTOR T DRAWN BY