HomeMy WebLinkAboutDrain Layers Permit 136 Pine Tree Lane TOWN OF 140UTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL
South Windsor, Connecticut
DRAIN LAYER'S PERMIT 381
Algo so 19 _
Pursuant to written application, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at 136 p1m 2M DR!* on the
1MMt side, between,
at premises owned by 13VO��Bo wsdowd
whose address isA
and to Y Lay House Drain, Repair House Drain, Lay Main, Other
for tial occupancy or use,
with =r 1) Family Units, with acres.
Type of Sewage to be connected under this permit:
SANITARY SEWAGE, INDUSTRIAL WASTES, OR
Connection will be made with AfX JA&h (6) "a 4d VJ10
Permit to be issued to JAIN As
the holder of Drain Layer's License No 1n Permit will expire on � �
The undersigned Drain Layer hereby agrees to all the terms and conditions set forth on the p�mi ermit-and the reverse s'i8e
thereof.. Applicant has received Town Permit No. and/or C H D Permit No.
for street excavation.
SPECIAL CONDITIONS WAN lt'!r!Y' tO Wftj Effig Md h.Mtrfi 9'1 MOU.--tMk
Signed i
Connection Charge Paid 73 Licensed Drain Layer
Poro so i (Sig) Issued by Wlih A• X t a Jr*
Tax Collector
Permit Fee: Paid $ISM
INSPECTION: Ckwmk #+*+,wrM�+ii%,.,,
--- INITIAL v l (Sig)
FINAL (Sig)
+ v
APPROVED 4 (Date)
(Sig)
INSPECTO .. : .:...
�S e
4
Q
NOTES C/ SOUTH WINDSOR POLLUTION CONTROL
/0 LOCATION l <'C
7e� OWNER
TYPE OF WORK itv` rr�L•
P .� DATE - ---PERMIT- PIPE ��
�'�' `� INSTALLER n�le
INSPECTOR t':r` DRAWN BY ;="rY