HomeMy WebLinkAboutDrain Layers Permit 135 Pine Tree Lane • TOWN OF S0 Tip WI N DSOR
DEPARTMENT OF POLLUTION CONTROL
South Windsor, Connecticut
DRAIN LAYER'S PERMIT
0 350
k ' 199—
.. 1 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 by1111111ou
so
whose address is illy
and to I 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
Permit to be issued to 1" 46
seem
the holder of Drain Layer's License No. Permit will expire on 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
Signed< 3
Connection Charge Paid $ Licensed rain Layer
. r (Sig) Issued by >� � 'job
Tax Collector
er it ee• IIIPaid $
INSPECTION: � ����
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
- �
(Sig)
' f. " IIQSPh 19T0 s-1
N
NOTES SOUTH WINDSOR POLLUTION CONTROL
LOCATION PlWc ,'r
OWNER ca L
TYPE OF WORK
DATE of � PERMIT PIPE arc.
INSTALLER tI ,
INSPECTOR x ":` DRAWN BY ` `