HomeMy WebLinkAboutDrain Layers Permit 24 Ravine Road N
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. NOTES SOUTH WINDSOR POLLUTION CONTROL
LOCATION a j i K e-
OWNER t�.✓�.
TYPE OF WORK - vj e r
DATE 11--;K5 - c PERMIT PIPE
INSTALLER is . i w ;. _.
INSPECTOR_ DRAWN BY ��
T—IRTIFT.
TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL
South Windsor, Connecticut BAP No.:
List No.: _ vim//E"
DRAIN LAYER'S PERMIT X? 2238
Pursuant to written applicatior, permission i hereby graJ�n//f�ed to the Licensed Drain Layer named herein to perform
the work indicated below at KC(V/ki6. !'G
on the
side, between l� P�f
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'ieverse side
thereof. Applicant has received Town Permit No. and/or C H D Permit No.
for street excavation.
pECIAL I
yo
Signed
Connection Charge Paid IJI) Licensed Drain Layer
Tax Collector Issued by
I/ , _ pv
Permit Fee:. Paid $ �5
INSPECTION: Check Number: 5 O(r
INITIAL
(Sig)
FINAL (Sig)
APPROVED �� (Date)
ECTOR (Sig)