HomeMy WebLinkAboutDrain Layers Permit 81 Scott Drive TOWN "OF L SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL B/P No.:
Li -�
South Windsor, Connecticut gay
st.No.: .�
DRAIN LAYER'S PERMIT ND - 2028 .
m ! � 19
Pursuant to written application, pe fission is h eby granted to the Licensed Drain Layer named herein to perform
the work indicated below at �� ✓l on the
side, between
at p mises owned by
whose address is
and to -Lay House Drain, Repair House Drain, Later; ther
for occupancy or use,
with Family Units, with acres.
Type of Sewage too be con gyred under this permit: ci4> icy
SANITARY SEWAGE ( �, I! NDUSTRIA ASTES ( O ( )
�r
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 CharpPaid 70`v sv Licensed Drain Ltr
oe
Issued by
Tay,/Collector
Permit Fee: Paid $
INSPECTION: Check Number: - JG_�
INITIAL (Sig)
FINAL dd (Sig)
APPROVED V (Date)
fig)
INSPECTOR
r
r
NOTES SOUTH WINDSOR POLLUTION CONTROL
LOCATION
OWNER
TYPE OF WORK
DATE PERMIT PIPE
INSTALLER G ok E o Asf
INSPECTOR DRAWN BY