HomeMy WebLinkAboutDrain Layers Permit 25 Wood Pond Road TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL B/P No.: _
T d South Windsor, Connecticut
List No.: _
1 DRAIN LAYER'S PERMIT N? 2444
ZLJ , 19 CP/
Pursuant to written ap l�tior, permission is hereby granted o the Licensed Drain Layer named herein to perform
the work indicated below at a /)' tsD {f�') on the
side, betw n
at premises owned by /a 6,07.c�
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 L �
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
n-aye/
1 9 7a Signed
Connection Charge Paid -Z/Q,0-p Licensed Drain Layer
Issued by
Tax Collector
Permit Fee: Paid $ d 6
INSPECTION: Check Number..
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
(Sig)
INSPECTOR
N
i
1
1 .
i
i
I
U
P:O T ES SOUTH WINDSOR POLLUTION COMM
LOCATION Lo -# c)a
0 IN
TYPE 0x WORK S A7
DATE / '/3` I PERMIT PIPE f '✓G
INSTALLER a ce
INSPECTOR S L DRAWN BY S