HomeMy WebLinkAboutDrain Layers Permit 54 Saginaw Street TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL
B/P No.:
South Windsor, Connecticut
List No.: -
DRAIN LAYER'S PERMIT NO 1666
, 19�
Pursuant to written applicatior, permission is ereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at 5 * am on the
side, between
at premises own e by Mbr6-q, _ ld1
whose address is
and to Lay House Drain, Repair House Drain, Lay-Main, Others
for �Q�� occupancy or use,
with e-71� Family Units, with
f ,��Er acres.
Type of Sewage to be connected under this permit: t X�ie..,
SANITARY SEWAGE INDUSTRRIAL WASTES .( ), OR ( )
Connection will be made with
Permit to be issued to 1Xw
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 :- i
Connection barge Paid 7 Licensed Drain Layer
6 Issued by
Tax Collector
/;S"
Permit Fee:. Paid $ _ �_ CD °
INSPECTION: Check Number: 0
INITIAL (Sig)
FINAL (Sig)
APPROVED_ �p — Z2_ �- ::z 9 (Date)
All-11 I)W,
INSPE T R (Sig)
GAR
00
-
\A�YE
rj n a S+r v-, -e_'�
N0�TES SOUTH WINDSOR POLLUTION CONTROL
LOCATIONf-
OWNER
TYPE OF WORK
DATE - PERMIT PIPE
INSTALLER--
INSPECTOR DRAWN BY