HomeMy WebLinkAboutDrain Layers Permit 178 Scott Drive TOWN OF SOUTH WINDSOR
DEPARTMENT OF POLLUTION CONTROL
B/P No.:
South Windsor, Connecticut
List.No.: _��'_LL��4=
DRAIN LAYER'S PERMIT NO 2054
, 19
Pursuant to written applicatior, permission is ^hereb ranted to the Licensed Drain Layer named herein to perform
the work indicated below at / 9� _�,4,,W $r
on the
side, between'
at premis s owned by y d t`/2
whose address is
and to Lay House Drain, Repair House Drain, _Lay-Main, Other
for � �.� occupancy or use,
with �=! 4 Family Units, with -----�� acres.
Type of Sewage to be connected under this permit. l/-/�h,r y�,.(.Z
SANITARY SEWAGE INDUSTRI r WASTES ( ), OR ( )
Connection will be made with
Permit to be issued to 17 1rt- Z.
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
f
Sro
�wd Signed ✓/ /� it^n ,
Connection Charge Paid y66•15 d Licens d Diain La ye ..
Issued by
Tax Collector
as-Sti Ifdos`//
Permit Fee: Paid $ /S D d_
INSPECTION: Check Number:
INITIAL (Sig)
FINAL (Sig)
APPROVED r (Date)
INSPECTOR