HomeMy WebLinkAboutDrain Layers Permit 885 Strong Road TOWN OF SOUTH WINDSOR
DEPARTMENT OF POLLUTION CONTROL
B/P No.:
Li
South Windsor, Connecti;ut Ost No.: _ �Dt�
DRAIN LAYER'S PERMIT NO 2182
SAS �-hrq Ad . , 19
Pursuant to written applicatior, permis'&fi n is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at 121JQ on the
side, betwee
at premises owned by
whose address is
and to Lay House Drain, Repair House Drain, Lay Main, Other
,
for
occupancy of 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. 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' H D'Permit No. _
for street excavation.
SPECIAL CONDITIONS
AO
Signed C4onnebarge Paid Licensed Drain Layer
Issued by
ctor
Permit Fee:. Paid $
INSPECTION: Check Number:
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
(Sig)
INSPECTOR
1'
N
, Cl
N
i
V, o-A
1
NOTES -`' j SOUTH WINDSOR POLLUTION CONTROL
LOCATION ,6 r ;
OWNER .a
TYPE OF WORK
DATE —'-�6 ' S'0 PERMIT ! �) PIPE
INSTALLER
INSPECTOR C DRAWN BY