HomeMy WebLinkAboutDrain Layers Permit 176 Pine Tree Lane TOWN OF SOU11i WIN DSOR-
DEPARTMENT OF POLLUTION CONTROL
_ . South Windsor, Connecticut
�40 46
DRAIN LAYER'S PERMIT N? 349
19 ----
Pursuant to written application, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at � on the
side, between
at premises owned
whose address is
and to x Lay 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, INDUSTRIAL WASTES, OR
Connection will be made with r'r
Permit to be issued to
the holder of Drain Layer's License No.' Permit will expire on e 19
The undersigned Drain Layer hereby agrees to all the terms and conditions set forth on the a permit n t e reverse si e
thereof. Applicant has received Town Permit No. and/or`C H D Permit No.
for street excavation.
SPECIAL CONDITIONS o_, to t
Signed ��. ,...� r' .''� } .
42
Connection Charge Paid $ / Licensed Drain Le ay' -rPOW ' —
L awls (Sig) Issued by - WINNOW#ft
Tax Collector
-Per nut ee• Paid $
INSPECTION: skm avow
INITIAL (Sig)
FINAL (Sig)
APPROVED /f/ (Date)
(Sig)
INSPECTOR
s.
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N
l 7 6
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NOTES SOUTH WINDSOR POLLUTION CONTROL
LOCATION 7G rRFk-
OWNER _rkl;e rE' Al
TYPE OF WORK -!/ r;✓ �G
DATE - PERMIT
INSTALIZR oh:v 4,414`Cxl
INSPECTOR r DRAWN BY