HomeMy WebLinkAboutDrain Layers Permit 105 Pine Tree Lane a!-p/ TOWN OF S96TH WINDSOR
DEPARTMENT OF POLLUTION CONTROL
South Windsor, Connecticut
j 24*222
DRAIN LAYER' S PERMIT N? 351
30 Jolr 19 73
Pursuant to written application, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at I" Pb! Tr ! fit! (10t on the
writ 391& side, between
at premises owned by Mum Id
whose address is !
and to x Lay House Drain, Repair House Drain Lay Main, Other
for 3*444 Sty occupancy or use,
with me M Family Units, with acres.
Type of Sewage to be connected under this permit:
SANITARY SEWAGI), INDUSTRIAL WASTES, OR
Connection will be made with munjush (6a) NJ-&us 3�
Permit to be issued to J*U Ae Lmsw
the holder of Drain Layer's License No. tip 188 Permit will expire on 30 $ r 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 Dada Wor to per, emok ud baafin anti! t"k.
Signed
Connection Charge PaidX W—$6-73 Licensed Drain Layer
p!r 3. N*M d,s (Sig) Issued by jWT" zdv"dS2 Jr.
Tax Collector
Permit Fee: Paid $115*N
Ck*& Airs
INSPECTION:
INITIAL '� �/ (Sig)
FINAL (Sig)
APPROVED G (Date)
(Sig)
INSPECTOR
N
i o.r'
S o
NOTES SOUTH WINDSOR POLLUTION CONTROL
LOCATION 0,S- Plytlf TkEC-
OWNER
TYPE OF WORK
DATE PERMIT 2.rl PIPE
INSTALLER
INSPECTOR es DRAWN BY Ifs"