HomeMy WebLinkAboutDrain Layers Permit 195 Scantic Meadow R TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL
South Windsor, Connecticut B/P No.:
List No.: _
DRAIN LAYER'S PERMIT NO 2281
Pursuant to written applicatior, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at /9S on the
side, between
�9 ` /l
at premises owned by��`y
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
3 , /- 0 Signed
Connection Char a Paid Vt-) Licensed Drain Layer
'4 — A
Tax Collector
Issued by
vo
Permit Fee: Paid $
INSPECTION: Check Number: --'-d-3 8-
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
INSPECTOR (Sig)
N .
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i
F E
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NOTES
SOUTH WINDSOR POLLUTION CONTROL
LOCATION 95 c ah
OWNER C
TYPE OF WORKh,` ar $v��y a era
--PATE a PERMI l PIPE
INSTALLER aGo
INSPECTOR DRAWN BY S�