HomeMy WebLinkAboutDrain Layers Permit 12 Spruce Lane TOWN - OF SOUTH WINDSOR � 4
DEPARTMENT OF POLLUTION CONTROL
South Windsor,.Connecticut ,
DRAIN LAYER'S PERMIT ? 286
19
Pursuant to written application, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at_ .4 � fs' c.5 � L9 on the
side, between
aft,premises owned by
whose address is
and to Lay House Drain, Repair House Drain, Lay Main; Other
for fY occupancy or use,
with er Family Units,with acres.
` Type of Sewage to be connected under this permit:
SANITARY SEWAGE INDUSTRIAL WASTES, OR
Connection will be made with
v
Permit to be issued to e w° 1. � � fiti//`J"/1//,EG✓c)/Tr'
the holder of Drain Layer's License No.W- -2V o�'J'a Permit will expire oo.<Z2�{Ji;-' 19` .
The undersigned Drain Layer hereby agrees to all the terms and conditions set forth on the permit and the reverse side
z
thereof. Applicant has received Town Permit No. and/or C H D Permit No.
for street excavation.
SPECIAL CONDITIONS '' .2 0
Signed
Connection Charge Paid $ �G� Licensed Drain Layer
... (Sig) Issued by
Tax Collector n
Permit Fee: Paid
INSPECTION:
AV
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
(Sig)
INSPECTOR
Y
N
� 12
fi
9 22 0
�p.
NOTES SOUTH WINDSOR POLLUTION CONTROL
LOCATION 12 spfo1c6
OWNER Hk-0 oRC
TYPE OF WORK �w L
DATE 6 PERMIT 2 SG PIPE G, "
INSTALLER
INSPECTOR IAI,l' DRAWN BY -�;
I ),
N
L�
N e,
T� N
NOTES SOUTH WINDSOR POLLUTION CONTROL
LOCATION 12
OWNER o r +- mnr4 6. Q
TYPE OF WORK +ion
DATE 6-2.2-`13 PERMIT PIPE
INSTALLER
INSPECTOR F. yl. DRAWN BY 1. IV1