HomeMy WebLinkAboutDrain Layers Permit 55 Pond Lane TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL
South Windsor, Connecticut B/P No.:
List No.: _
DRAIN LAYER'S PERMIT NO 2320
, 19
Pursuant to written applicatior, p7.ionis' hereb granted to the Licensed Drain Layer named herein to perform
the work indicated below at on the
side, between
at premises owned by
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 connected under this permit:
SANITARY SEWAGE ( )., 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. f'
SPECIAL CONDITIWl
l
Signed
Connection Char i �(�_ LZ Licensed Drain Layer
Issued by
TT Collector
Permit Fee Paid $ _ 2-
INSPECTION: Check Number: 3 ytl) .
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
INSPECTOR (Sig)
N
F
NOTES SOUTH WINDSOR POLLUTION CONTROL
LOCATION S"_3_ o� L
OWNER
TYPE OF WORK Sa d -f"ewP u erg
DATE 7�—XI 1 PERMITv�o PIPE ''!'✓
INSTALLER s
INSPECTOR S DRAWN BY L