HomeMy WebLinkAboutDrain Layers Permit 63 Willow Street TOWN OF SOUTH WINDSOR
DEPARTMENT OF POLLUTION CONTROL
B/P No.:
Li
South Windsor, Connecticut ly ya
st.No.: _ 7
DRAIN LAYER'S PERMIT NO 1502
19 ?�
Pursuant to written applicattiio�r, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at (5,?J' W/.CLD)y s7-, on the
side, between
at premises owned by a/rd� W,12 A11"K
whose address is
and to L Lay House Drain, Repair House Drain, Lay Main, Other
for X1� /IP6)VW7-ti occupancy or use,
with Q/ Family Units, with acres.
Type of Sewage to be connected under this permit:
SANITARY SEWAGE (X), INDUSTRIAL WASTES .( ), OR ( )
Connection will be made with
Permit to be issued to
the holder of Drain Layer's License No. Permit will expire oh 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
Signed
&g��
Connection Charge Paid- l?,51 Licensed Drain Layer
n t Issued by
Tax Collector
s�Permit Fee:. Paid $
INSPECTION: Check Number:
INITIAL (Sig)
FINAL (Sig)
APPROVED "��j '�� (Date)
(Sig)
INSPf,CTOR
J
i
t C,o 916
3• ''I
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NOTES SOUTH WINDSOR POLLUTION CONTROL
LOCATION 6 3 WAI o
OWNER W D C
TYPE OF WORK Yov s6 CeAuNce r)v A(
DATE 9-1 11 PERMIT ),TO PIPE
INSTALLER 15 G u1 S
INSPECTOR DRAWN BY