HomeMy WebLinkAboutDrain Layers Permit 39 Pine Tree Lane 296D ; TOWN OF `SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL
4—.
South Windsor, Connecticut
`.� DRAIN LAYER' S PERMIT N? 356
t A06, , I 9?3
Pursuant to written application, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at 39 Pdes Tr" �Ld;'r 72) on the
4"t side, betweenN.gftffj" & SM10"!t Aro
at premises owned by ' art
whose address is_W*
and to XLay House Drain, Repair House Drain, Lay Main, Other
for 3nIMLASSAW occupancy or use,
with qt M Family Units, with acres.
Type of Sewage to be connected under this permit:
SANITARY SEWAGE, INDUSTRIAL WASTES, OR
Connection will be made with six iaok (6) PIROUS Pip*
Permit to be issued to J!$ A.
the holder of Drain Layer's License No.V9-266188 Permit will expire on 00to 1 _
The undersigned Drain Layer hereby agrees to all the terms and conditions set forth on the permit and the reverse side
I thereof. Applicant has received Town Permit No. and/or C H D Permit No.
for street excavation.
SPECIAL CONDITIONSAISf LOT ft P009 42WA Md ba4k= SOUS tW*
1
r
Signed
Connection Charge Paid -31- Licensed Drain Layer
P*r S. Ne"s (Sig) Issued by A. 9ttl"lk11Mther Jr.
Tax Collector
Permit Fee: Paid $13'"
INSPECTION: Cheek X=b*r-.11�
INITIAL P J (Sig)
FINAL S (Sig)
APPROVED 5 `7 -? (Date)
(Sig)
IR§IP—ECTOR
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3 qj-0
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NOTES SOUTH WINDSOR POLLUTION CONTROL
LOCATION 39 O' IV IT )WFL-
OWNER koeToel 191ZAVAO
TYPE OF WORK
DATE -7-fPERMIT PIPE 6'Cr rTc
INSTALLER GAm�'ow
INSPECTOR J' DRAWN BY es