HomeMy WebLinkAboutDrain Layers Permit 238 Skyline Drive TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL gip No.:.
South Windsor, Connecticut b
List.No.:
DRAIN LAYER' S PERMIT N? 1322
— 9— , 19 ��
Pursuant to written appli at' r, p mission/I s ereby granted to th Lice s Drain Layer named herein to perform
the work Xidicated below at ! !//',GU 7 on the
et side, betwee
at premises owned by VO ///llU�
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 AS SS . / OR
Connection will be made with ri r
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 Charge Paid icensed Drain Layer
Issued by
Tax Collector
Permit Fee: Paid $ _�S'' CC)
INSPECTION: Check Number:
INITIAL (Sig)
FINAL (Sig)
APPROVED t'a (Date)
INSPECTOR (Sig)
I
i
NOTES SOUTH WINDSOR POLLUTION CONTROL
LOCATION
OWNER
TYPE OF WORK
DATE -/o-77 PERMI 22 PIPE
INSTALLER Q
INSPECTOR G/' DRAWN BY l"�
$ A 4 1
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