HomeMy WebLinkAboutDrain Layers Permit 38 Scantic Meadow Ro %JWN Ut 5OUTH WINDSOR
DEPARTMENT OF POLLUTION CONTROL
South Windsor, Connecticut B/P No.:
List No.: __�/g
DRAIN LAYER'S PERMIT Na 2309
i^
_ 4' �t / ' 19 �
Pursuant to written applicatior, ermiss ion is hereby granted to th Licensed Drain Layer named herein to perform
the work indicated below at
on the
side, betw en
at premises owned
whose address is
and to Lay House Drain, Repair House Drain, La -Main,Man Other
for '
occupancy or use,
with Family Units, with
acres.
Type of Sewage to be connected under this permit:
SANITARY SEWAGE ( j, 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 1
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
�( �! d l
Signed
Connection Charge Paid b J Licensed Drain Layer
Tax Collector Issued by
,1 /D
Permit Fee:. Paid $ _ l�
INSPECTION: Check Number:
INITIAL
(Sig)
FINAL (Sig)
APPROVED (Date)
(Sig)
INSPECTOR
c/SA Y
H3Of
y
cIV
37, Cl
�38
5
I ;may
NOTES SOUTH WINDSOR POLLUTION CONTROL
LOCATION 3 cf 5'��
OWNER s _
e'. .�lrl t'v
TYPE OF WORK �i�✓/i L,�y-7—,
DATE / PERMIT PIPE v�
INSTALLER Go A52!:�
INSPECTOR42 DRAWN BY