HomeMy WebLinkAboutDrain Layers Permit 186 Scantic Meadow R (2) E vn 11 yr 12vv i n R 11,IVJVI(
DEPARTMENT OF POLLUTION CONTROL
B/P No.:
South Windsor, Connecticut
List No.:
DRAIN LAYER'S PERMIT N? 2278
, 19
Pursuant to written applicatior, per ission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at /"Cd on the
side,between
at premises owned byp�
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
Connection Charge Pai 7l� Licensed Drain Layer
Y
Issued by
a Coll for
Permit Fee: Paid $ Z'
INSPECTION: Check Number: �5
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
(Sig)
INSPECTOR
N
i
�= 6,
�1
r=,
NOTES SOUTH WINDSOR P LLUTION CONTROL
LOCATION
OWNER
TYPE OF WORKSr c<.1 F
PERM TT P-7 PIPE o"jD/C.
INSTALLER ,l
INSPECTOR DRAM BY