HomeMy WebLinkAboutDrain Layers Permit 1010 Strong Road TOWN OF SOUTH VI N DSOR
DEPARTMENT OF POLLUTION CONTROL
South Windsor, Connecticut B/P No.: /
List No.: Jr W
DRAIN LAYER'S PERMIT
O 1592
Pursuant to written applicatior, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at S JMeX4i
on the
side, between
at premises owned by O�D/%Z/O pl,., `�lc-�j� rd 4- /vy -72-y
whose address is_ltglo
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 WASTES .( ), OR ( )
Connection will be made with
Permit to be issued to
the holder of Drain Layer's License No. S�J 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
v/ Z��y -` -3/6
G�'Lfl% Signed
Connection Charge Paid Licensed Drain La er
Issued by
Tax Collector --Z�ff
�UU
Permit Fee: Paid $ __z
INSPECTION: Check Number: d 77
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
(Sig)
INSPECTOR
i' Y
O
N
ti &41b
U �Li � L
:r-F
ST�
NOTES SOUTH WINDSOR POLLUTION CONTROL
LOCATION a D
OWNER
TYPE OF WO
DATE PERMIT PIP i
INSTALLER
INSPECTOR-YLoQ DRAWN BY