HomeMy WebLinkAboutDrain Layers Permit 176 Tumblebrook Driv F 3_ • TOWN 1` SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL
B/P No.:
South Windsor, Connecticut
List.No.:
DRAIN LAYER'S PERMIT N? 1669
r Z 19
Pursuant to written application, permission is hereby ranted to the Licensed Drain Layer named herein to"perform
the work indica below'at belo at /o
C
l n/ S - ?�rK�pl�b
<�t �� ' on -
side, between•� {
at premises"owned by
whose address is
and to LayHouse brain, Repair House Drain, Lay Main, Other
for occupancy or use,
with Family Units, with acres.
Type,of Sewage to be connected under this permit:
W ✓'
-- SANITARY`
AGE S ( 1, INDUSTRIAL WASTE ( ), OR ( )
Connection will be made with V
,
i -
- - .?
Permit to;be issued ro r-
ihe holder of brain Layer'szLiS.etise No. Permit witlegpue on 19
The undersigned Djain Layer hereby agrees to all the terms_and conditions set forth on.the per` t and the reverse side
' thereof. Applicant has received Town Permit No, *and/or C H D`Permit No.' f f •i''
for street e
s.�ca;Ttion
SPECIAL C010IT'ION
is
. . C-
T. • f - t -
.g -
` Connection Chat a Paid 7 Z
y
g Si ne :.L•icetilabd D a er
_, - �� .. -... ... • :. 1. - ,' •/�' Z: a
/. 3
Issued by
Tax Collector
Permit':Nee:. Paid $
INSPECTION: Check Number: �O
INITIAL (Sig)
FINAL (Sig)
APPROVED 2 9' (Date)
(Sig)
•
WSPECTOR
if
. I 0
1
NOTES SOUTH WINDSOR POLLUTION CONTROL
C 1 Co ; c:'<_ ' LOCATION Lo f-- � S
OWNER
TYPE OF 4ORK
DATE �- PERMIT PIPE G " v�
INSTALLER
INSPECTOR DRAWN BY / �'