HomeMy WebLinkAboutDrain Layers Permit 29 Rainbow Trail TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL
South Windsor, Connecticut B/P No.:List No.: _JL/ q
�CF-p _
DRAIN LAYER'S PERMIT NO 1819
Pursuant to written appliccaatior,, permission is hereby7ranted to the Licensed Drain Layer named herein to perform
the work indicated below at f C5 T ' / /
7 T� on the
v v
side, between
at premises owned by �? /� 6 -L 5 1
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.
SPECIAL CONDITIONS
Signed
ConneqU*&w Charge Paid Licensed Drain Lay
001,
Issued by
Tax Collector
3 2- P rmit Fee: Paid $
INSPECTION: Check Number:
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
(Sig)
INSPECTOR
��6'�hc�_
�f � �7
RR)N,s o w 7PIA I L-----
NO__.TES SOUTH WINDSOR POLLUTION CONTROL
LOCATION`°//
OWNER 0
TYPE OF WORK
DATE
INSTAR PERMIT PIPE
INSPECTOR DZ-- DRAWN BY J>�