HomeMy WebLinkAboutDrain Layers Permit 1005 Strong Road TOWN OF SOS WI N DSOR
DEPARTMENT OF POLLUTION CONTROL
B/P No.:
South Windsor, Connecticut
List No.:
DRAIN LAYER'S PERMIT NO 1586
Pursuant to written applicatior, permission is hereby granted to he Licensed Drain Layer named herein to perform
the work indicated below at - 110d '
on the
��� s�etween
at premises owned by
whose address is
and to �ay House Drain, Repair House Drain, Lay Main, Other
for �jd-r✓� � �� occupancy or use,
with Family Units, with acres.
Type of Sewage to be connected under this permit: .cam
SANITARY SEWAGE INDUSTRIAL WASTES ( ), OR ( )
Connection will be made with (n V r_
Permit to be issued to C ,�6411 e,
the holder of Drain Layer's License No. 2-n CA ?_ 4- 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
-,,K , 1 q7q
11 Signed
Connection Charge Paid Q0 Licensed Drain ayer
131 Issued by
Tax Collector
f� 1101-/
P-10r` � (�� Permit Fee: Paid $
INSPECTION: Check Number: l 2-a —5
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
000,
(Sig)
INSPECTOR
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2 el eIA16 4�C-, �
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NOTES SOUTH WINDSOR POLLUTIO CONTROL
LOCATION , S
OWNER
TYPE OF WO S
DATE PERMIT PIPE
INSTA LE
INSPECTOR DRAWN BY