HomeMy WebLinkAboutDrain Layers Permit 60 Willow Street TOWN OF SOUTH, Wi N DSOR
DEPARTMENT OFOOL UTION CONTROL
South Windsor, Connecticut
#` t S-40
DRAIN LAYER'S PERMIT N? 322
' + 19
Pursuant to written application, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below'at on the
i side,between �
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:
tS�INITARY":SEWAFs INDUSTRIAL WASTES; OR
Connection will be made withA11041A in
Permit to be issued to- 46
"
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 sid
thereof. Applicant has received Town Permit No. and/or C H D Permit No.
for street excavation.
SPECIAL CONDITIONS low
Signed
Connection Charge Paid Licensed Drain Layer
pass
(Sig);, Issued by :
Tax Collector `
P rmit F :: Paid
.h INSPECTION:
INITIAL ._. (Sig)
FINAL (Sig)
APPROVED_ ,L g4#7I (Date)
(Sig)
INSPIEC OR
N
NOTES SOUTH WINDSOR POLLUTION CONTROL
Mar To scA`E" LOCATION La
OWNER E w,aem c E
0 TYPE OF WORKS C►
DATE ® - PERMIT 2.Z,. PIPE(*"
INSTALLER L4
►►, s INSPECTOR DRAWN BY