HomeMy WebLinkAboutDrain Layers Permit 7 Scott Drive TOWN OF SO,U 'H WtNDSOR
DEPARTMENT OF POLLUTION CONTROL gip No.: "
South Windsor, Connecticut / ��
List.No.:
DRAIN LAYERS PERMIT N? 1959
.., 19
Pursuant to written applicatior, petmifssip isihereby,granted to the Licensed Drain Layer named herein to perform
the'work indicated below at on the
side; between ,.
i! Y
at premises owned by �� �-•-- `. ✓fora�7 f� �? lj G' t�r� r ``
whose address is
and to "Lay Flouse Drain, Repair House Drain, Lay-Main, Other
for /�)� ,. / occupancy or use,
�j
with �. f ,fZ Family Units; with acres.
Type of Sewage to be connected under this permit: �"1,tztr„r
SANITARY SWAGE (. /')j',-INDUS=- AL WASTES.(; ),_ OR ( )
Connection will be made with_
Permit to;N!.issued to .. .
the holder of D;, Layer's License ]1To, 13erniit well egpire on 19
The undersigned Dr rn Layer.he eby agrees to allgth terNZ and conditions Pets forth on the peanut and the reverse side
thereof. Applicant has received Town Permit Noi and/or C H D 'Ptnit 1�10
s eta awauon _ _.
SPECIAL,CONDITIONS
Signec)1G
Connection Charge Paid'' I lcerfsed Dth'in Layer
l' 40 'jssued by
Tax Collector
Q!�
Permit Fee:. Paid $
INSPECTION: Check Number:
.�L'L�,
INITIAL (Sig) Cy :
- FINAL (Sig)
APPROVED (Date)
(S18)
INSPECTOR
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NOTES SOUTH WINDSOR POLLUTION CONTROL
LOCATION C o'-? Del j�g
OWNER G`
TYPE OVr WORK
DATEfa ER- PI-P—E-/,--
INSTALLER
INS ECTOR DRAWN BY