HomeMy WebLinkAboutDrain Layers Permit 870 Pleasant Valley TOWN OF SOUTH WINDSOR
DEPARTMENT OF POLLUTION CONTROL
B/P No.:
South Windsor, Connecticut --� 4
List No.:
DRAIN LAYER'S PERMIT N? 2284
, D , 19,
Pursuant to written applicatior, permission i hereby granted to the Lice n ed Drain Layer named herein to perform
l� � I
the work indicated below at 1} '7� ��fll S4 r/ l cf l��y /
on the
side, between
�
at premises owned by ( l t:O U he 1 Yi 6i-
whose address is
and to Lay House Drain, Repair House Drain, Lay Main, Other
for
occupancy or use,
with Family Units, with acres.
Type of Sewage to be
be connected under this permit:
SANITARY SEWAGE (V ), INDUSTRIAL WASTES ( ), OR
Connection will be made with
Permit to be issued to
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 ? (`
Connection Charge Paid ��0 Licensed Drain Layer
Issued by
Tax Collector
Permit Fee: Paid �S f
INSPECTION: Check Number:
_ INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
(Sig)
INSPECTOR
N
i
NOTES SOUTH WINDSOR POLLUTION COMRO
LOCATION
OWNER
TYPE OF WORK S24 ry r
DATE 3- 3 $/ PERMIT a PIPE 6
INSTALLER L vz:
INSPECTOR DRAWN BY C_