HomeMy WebLinkAboutDrain Layers Permit 39 Rosemary Lane TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL BAP No.:
South Windsor, Connecticut
List No.: _
DRAIN LAYER'S PERMIT 1
25
J� , 19�.
Pursuant to written applic tior peSLmissioaj hereby granted yo the Licens DDrr�ain Layer named herein to perform
the work indic�t�4 below at �' ' r, "i (� on the
/G/ ! . side, bet----
at premises owned by
whose dress 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 (\A, INDUSTRIAL W TES . OR ( )
Connection will be made with ®1 V
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
✓i
ti
Signed f
Connection Charge Paid Licensed Dr Layer
nyIssued by
Tax Collector >
Permit Fee:. Paid $
INSPECTION: Check Number:
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
(Sig)
INSPErt,OR
r
P- 46
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NOTES SOUTH WINDSOR POLLUTION CONTROL
LOCATION/ - 2
OWNER ,,
TYPE OF WORK u
DATE - ERMIT PIPE
INSTALLER .
INSPECTOR l C'T/ DAAWN BY �/
TOWN OF SOUTH
WINDSOR
TOWN HALL
SOUTH WINDSOR, CONN. 06074
DEPARTMENT POLLUTION CONTROL
Date
The Sanitary Sewer
.� . . Septic System .. . . . . '.
If
�. . �
at . . ft
#. . . " .
has
inst
or lot alled and completed
. the Town of South Windsor ordinances
in accordance with
and regulations.
Accepte d Approved
2-�-2t2
Date
/ d �"Al