HomeMy WebLinkAboutDrain Layers Permit 160 Pine Tree Lane TOWN OF , Q TH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL
South Windsor, Connecticut
DRAIN LAYER'S PERMIT N? 495
NOT 7 11973
Pursuant to written application, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at 160 Pin! Tree La. on the
Y*at side, between Bewedict & Poem La-
at premises owned by Terrence Clark
whose address is s"*
and to X Lay House Drain, Repair House Drain, Lay Main Other
for reei.dential occupancy or use,
with (IIA 0) Family Units, with acres.
Type of Sewage to be connected under this permit:
SANITARY SEWAGI), INDUSTRIAL WASTES, OR
Connection will be made with Sfa inch (6) plastic Pipe
Permit to be issued to John LAsDn
the holder of Drain Layer's License No w9-206188 Permit will expire on Jan . 7 1923
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 Drain laYar tO PUMP9 crush and backtill septic tank
Signed
Connection Charge Paid $ 10/23,623 Licensed Drain Layer
Per. T. Hanisc (Sig) Issued by Ph Ral A. Starkaeather X r.
Tax Collector
Permit Fee: Paid$ 15.00
INSPECTION: Check
INITIAL z/ A 12 , 151 � /_;r (Sig)
FINAL j (Sig)
APPROVED (Date)
(Sig)
INSPECTOR
N
1
1
I
NOTES SOUTH WINDSOR POLLUTION CONTROL
LOCATION tA.
OWNER �<`�a'r�i •`, �,�,,.;
TYPE OF WORK
DATE ;4 7 ',v' PERMIT PIPE ,,),
INSTALLER
INSPECTOR le I DRAWN BY 77