HomeMy WebLinkAboutDrain Layers Permit 154 Rosemary Lane TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL
B/P No.:
South Windsor, Connecticut -,� //136
List.No.: (�,W
DRAIN LAYER"S PERMIT 1668
►5� �t941.�m ---s�L.�.� 2.2 , 19�
Pursuant to written applicatior, permission isieibyagr4an't—ed to the Licensed Drain Layer amed herein to perform
C7
the work indicated below at F on the
side, between
at premises owned by
whose address is
and to Lay House Drain, Repair House Drain, Lay-Main, _Other
for /fd occupancy or use,
with Family Units, with acres.
Type of Sewage to b onnected under this permit: �C,p-7yi
SANITARY SEWAGE j, 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
Connection Charge Paid 6-- Lice rain L ye
37 e Issued by
Tax Collector
Permit Fee:. Paid $ 1�1
00
INSPECTION: Check Number: c2—2 2
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
INSPECTOR (Sig)
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1/
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NOTES SOUTH WINDSOR POLLUTION CONTROL
LOCATION
OWNER
TYPE OF WORK
DATE PERMIT PIPE 'S c
INSTALLER
INSPECTOR '. ! DRAWN BY