HomeMy WebLinkAboutDrain Layers Permit 14 Spruce Lane TOWN Of S tJT 14 WI N DSOR
DEPARTMENT OF POLLUTION. CONTROL
B/P No.:
South Windsor, Connecticut
List No.:
DRAIN LAYER'S PERMITQ. 614
-- l9
Pursuant to writt4ft applicatior ptrmission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below.at on the
y side, between
at premises owned by—
whose address is
and to X ,ay House Drain, Repair House Drain.; La--Main, Other
for ;.: -.. .,. :.;:: .,
_ occupancq or use,
with Family Units,,,with acres.
Type of Sewage to be connected under this permit:
SANITARY SEWAGE ( j, INDUSTRIAL WASTES . OR .( )
Connection will be.'made with Alft ! P141
Permit to be issued to t'
the holder of Drain Layer's License NQ, :'.Perm t-4iil 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. No. and/or C H D Permit No.
for treet excavation.
SPECIAL CONDITIONS
agned
Connection Charge Paidt Lreensed Drain Layer
ftwA X* 0111141111 Issued by Wyk Ae
Tag Collector
Permit Fee:. Paid
INSPECTION: Check Number: ,
INITIAL s (Sig)
FINAL (Sig)
APPROVED (Date)
-� (Sig)
INSPECTOR
a
N
NOTES SOUTH WINDSOR POLLUTION CONTROL
LOCATION L 4
OWNER
TYPE OF WORK
DATE PERMIT l/lam PIPE eVC,
INSTALLER ®��,,� �.Bf<•l
INSPECTORS DRAWN BY