HomeMy WebLinkAboutDrain Layers Permit 60 Ronda Drive TOWN OF SOUTH WINDSOR i
"DEPARTMENT OF POLLUTION CONTROL 1
B/P No.:Li
South Windsor, Connecticut st.No.: ,y,
DRAIN LAYER'S PERMIT NO 2012
Pursuant to written applicatior, permission is hereby granted to the Licensed Drain.Layer named.herein to"perform
the work indicated below at 16 11GaC( v/ '
on the
or-P side,.between
at pre ses 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
,r! thereof. Applicant has received Town Permit No. and/or C H D Permit No.
for street excavation.
SP> CIAL.GONIITION .
Signed ' L �l�r�t-vC
Connection Charge Paid_ 00 ice
nsed Drain Layer
Issued by
Tax Collector
Permit Fee:. Paid $
INSPECTION Check Number: y _
INITIAL ,
(Sig) ( ��.�1 c l�.'J,• .
FINAL (Sig)
APPROVED r- 0 (Date)
(Sig)
INSPECTOR
r
s
f
N
y.. x
t r
:<7
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NOTES SOUTH WINDSOR POLL ION CONTROL
LOCATION f, ,
OWNER
TYPE OF WORK TAAi. ' f `�;
DAT -- _:PERMIT r PIPE'
INSTALLER JE1,
INSPECTOR- DRA BY
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