HomeMy WebLinkAboutDrain Layers Permit 34 Woodcock Lane TOWN OF SOUTH WINDSOR
DEPARTMENT OF POLLUTION CONTROL
B/P No.:
South Windsor, Connecticut
List No.:
DRAIN LAYER' S PERMIT N? 2408
, 19�
Pursuant to written applicatDior, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at l (YhW�5 #- -j-4/ on the
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 a 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
19�0� Signea
Connection Charge Paid
f Q U Licensed Drain Layer
�lL �L lit Issued by
Tax Collector
Permit Fee: Paid $ =�
INSPECTION: Check Number: ���
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
(Sig)
INSPECTOR /'
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To
itdTES SOUTH WINDSOR OLLUTION CON,?rTtqL ,
LOCATION
OWNTEP. Wr U~ CGa c
TYPE OF WORK
DATE -SIPEWfIT -V C) PIPE
INSTAL]F R p G
INSPECTOR . C DRAWN BY