HomeMy WebLinkAboutDrain Layers Permit 39 Wentworth Drive TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL
B/P No.:
South Windsor, Connecticut p /
List No.: _
DRAIN LAYER'S PERMIT 'O 2163
, 19
Pursuant to written applicatior, permission is hereby granted to the Lic used Drain Layer named herein to perform
the work indicated below at
On' the
side, betwe n
at premises owned by
whose address is
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. 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
Signea
Connection ge Paid 8 e v Licensed Drain Layer
Issued by
Tax Collector
y Permit Fee: Paid $/v 6
INSPECTION: Check Number:
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
(Sig)
INSPECTOR
1
NOTES SOUTR WINDSOR POLLUTION CONTROL
LOCATION a4 a
OWNER 4 X ot," r`
TYPE OF WORK 3SPwA r'
DATE F 7- 80 PERMIT PIPE c
INSTALLER C o o t � .
INSPECTOR S• C..-. DRAWN BY
N
45 v
1
I /
I
W Y
ES SOUTH WINDSOR POLLUTION CONTROL
LOCATIONIa
OWNER L)C �h 2�'
TYPE OF WORK S s w-e r
DATE - '8 PERMIT /78 PIPE (A ' �G
INSTALLER 0,0 V f
-- INSPECTOR DRAWN BY S .