HomeMy WebLinkAboutDrain Layers Permit 609 Rye Street TOWN OF SOUTH WINDSOR
DEPARTMENT OF POLLUTION CONTROL
B/P No.: _
South Windsor, Connecticut
List No.:
DRAIN LAYER'S PERMIT N? 2.409
7� , 19e_
Pursuant to written applicatior, perm' ion��eby granted to the Licensed Drain Layer named herein to perform
the work indicated below at % on the
side, between
at premises 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
thereof. Applicant has received Town Permit No. and/or C H D Permit No.
for street excavation.
SPECIAL CONDITIONS
Signed W
Connectio rge Paid "7 Z �� icensed Drain Layer
Issued by
<Tax Collector
Permit Fee: Paid $
INSPECTION: Check Number: P U
INITIAL (Sig)
FINAL (Sig) 7— Q
01'—
APPROVED (Date)
(Sig)
INSPECTOR
p
t
1
i
1
4._
DOTES SOUTH E4INDSOR POLLUTION COlgrROL
LOCATION �? .
OWti"ERr
TYPE Or WORK/
DATE 7- a�r- RMIT 4 PIPE
INSTALLER °-
INSPECiOR C-- DRAWN BY S �--