HomeMy WebLinkAboutDrain Layers Permit 36 Rustic Lane TOWN OF SOUTH WI N DSOR
DEPAhTMENT OF POLLUTION CONTROL BAP No.:
South Windsor,Connecticut
List No.: '�—
DRAIN LAYER'S PERMIT
O 231
3
Pursuant to written applicatlior, permission is hereby�grranted to the
/Licensed
� Drain Layer amed herein to perform
the work indicated below at t➢'I # r1 D� l�.�a[iL l' vC 01I LP L��+U7/.' �j�3�' on the
side, betty en
at premises owned by cfwy
whose address is
and to Lay House Drain, Repair House Drain, Lay-Main, Other
for occupancy or use,
01
with " , L"Z Family Units, with acres.
Type of Sewage to be connected under this permit:
SANITARY SEWAGE INDUSTRIAL WASTES .( ), OR ( j
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
#-P/-f( Signed
Connection Charge Paid% yD D D L Licensed Drain La
e
Issued by: . y 3 . T
Tax Collector
Permit Fee: Paid $
INSPECTION: Check Number:
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
(Sig)
INSPECTOR
N
j I
i
NOTES SOUTH WINDSOR POLLUTION CONTROL
LOCATION L o 7_» n
OWNER
TYPE OF WORK .S-,
DATE 5`-/8` l PERMIT ' 7 PIPE
INSTALLER Fc_
INSPECTOR DRAWN BY _