HomeMy WebLinkAboutDrain Layers Permit 21 Robert Drive { ` TOWN OF SOUTH WINDSOR
DEPARTMENT OF POLLUTION CONTROL
B/P No.:
South Windsor,Connecticut G,
List No.: _ v
DRAIN LAYER'S PERMIT NO 1340
/1-3- , 19/
Pursuant to written applicatior, permis s h reby granted the Licensed Drain Layer named herein to perform
the work indicated below at �' siod,4e--'TTJ^/f"�.. on the
side, between
_ - `mi at premises owned byl! /zJ
whose address is
and to K 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 ( , INDUSTRIA Al�! ), 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 Licensed rain yer
//—/ 7 T
Issued by
Tax Collector r
Permit Fee Paid $ _ V`� c
INSPECTION: Check Number: 44-1 3
INITIAL (Sig)
FINAL 7 (Sig)
APPROVED 1 — (Date)
y6kd e. ° (Sig)
INSPECTOR
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SOUTH W INOSO.0 POU-UTi N CONTROL
LOCATION Z/
Tv V L- -OF vio P,( z vce Ce11,117, C,
( '\ _ 11-3-7 7 PERMi i/ U PIPE ,
b iNS YA_L Ic , .
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INISaFCTIO1 - -.li`'�_... - r)PAWN[3Y l
lJ�
ivy
,41 _
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