HomeMy WebLinkAboutDrain Layers Permit 75 Tumblebrook Drive TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL BAP No.:
South Windsor, Connecticut
List.No.:
DRAIN LAYER'S PERMIT N? 1623
19�
Pursuant to written applicatior, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at 2 'I Lk m 6 1 e- 0 rO c on the
side, between f`
at premises owned by H ier Lerr V K U e n t,
whose address is 7.5 T(a m b -e bra U le,
and to —L�ay House Drain, Repair House Drain, Lay-Main, Ot r
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 �t l� G
Permit to be issued to
the holder of Drain Layer's License No. ZZO S; i q' Permit will expire on 19�
The undersigned Drain Layer hereby agrees to all the terms and conditions set forth on the permit and t e reverse side
thereof. Applicant has received Town Permit No. and/or C H D Permit No.
for street excavation.
SPECIAL CONDITIONS
f q Signed
Connection Charge Paid 5- 11177 Licensed Drain Layer
13 9 3 Issued by
Tax Collector v
Permit Fee: Paid $ _�?-_t 00
INSPECTION: Check Number: 23-3
INITIAL (Sig)
FINAL (Sig)
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APPROVED �C �`.._ ,mare)
(Sig)
INSPECTOR
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NOTES SOUTH WINDSOR POLLUTION CONTROL
LOCATION
OWNER
TYPE OF WORK
DATE : '-,PERMIT f v' PIPE ';''
INSTALLER
INSPECTOR - t'a cr ;DRAWN BY