HomeMy WebLinkAboutDrain Layers Permit 193 Tumblebrook Driv TOWN OF SOUTH W1 N DSOR
DEPARTMENT OF POLLUTION CONTROL
B/P No.:
South Windsor..Connecticut
List.No..:
DRAIN LAYER'S- PERMIT '' N99. 670
' 19
Pursuant to written applicatior, permission is hereby ranted to the Licensed Drain Layer named herein to perform
the work indicated below at i•1�, ebroad
on the pl'
side, between
at premises owned'by_C/I f
whose address is _
and to Lay Hduse biaia, Repair`House Drain, _rLay'Main, Other"
for occupancy or use,
with n Family Units.,.with,,," .,. acres.
Type of Sewage to be connected under this permit:
SANITARY SEWA (�j, INDLISt7tIA1 OR,{
Connection will be made with '(n
r.
Permit to;be issued to e
the holder of Drain,Layer's License lvo i' Permit will a pue on " 19
The undersigned,Drain Layer hereby agrees to all the.terms:and conditions set foith on the permit and 'the reverse side
thereof. Applicant has received Town Permit No. itid/ok C 14D'Permit'No*.
foratr-et egcnvation
SPECIAL CONDITIONS'-
?� Signed
o ,
Connection Charge Paid R.a '' +• Licensed D W4yer
/,5 s'
- Tax Collector Issued by
/ 6 Q
Permit Fee Paid $
INSPECTION: Check Number: y 6
INITIAL (Sig)
FINAL (Sig)
APPROVED 72 (Date)
CTOR (Sig)
N
t�
DC69
G� K.
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NOTES SOUTH WINDSOR POLLUTION CONTROL
LOCATION 777U
OWNER
' TYPE OF WORK
DATE PERMIT 0 PIPE ✓c
INSTALLER
INSPECTOR 9L— DRAWN BY �-