HomeMy WebLinkAboutDrain Layers Permit 14 Steep Road TOWN OF �SO'lJ` A WI N DSOR
DEPARTMENT OF POLLUTION CONTROL B/P No.:
South Windsor, Connecticut
List No.:
DRAIN LAYER'S PERMIT -�C> s,
M 622
Pursuant to written application, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at 14 StM ft. r, on the
sau side, between = " a Ovehm
at premises owned by ftbWt bosom
whose address is 000
and to X Lay House Drain, Repair House Drain, Lay Main, Other
for occupancy or use,
with-0110 Family Units, with acres.
Type of Sewage to be connected under this permit:
SANITARY SEWAGE (X), INDUSTRIAL WASTES ( ), OR ( )
Connection will be made with 14" V,000P•
Permit to be issued to �
the holder of Drain Layer's License No. 920 Permit will expire on S"*# 12 1974
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 t%l',V : 1 Licensed Drain Layer
poll* e XIssued by A&I06 40 s P!0"�-'!
Tax Collector
Permit Fee: Paid $
INSPECTION: Check Number:
INITIAL `� r' ..�. (Sig)
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FINAL (Sig)
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APPROVED— "�: �;_, ".�=jam` (Date)
f t (Sig)
INSPECTOR
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NOTES SOUTH WINDSOR POLLUTION CONTROL
LOCATION
OWNER
TYPE OF WORK
DATE PERMIT PIPE
INSTALLER
INSPECTOR DRAWN BY