HomeMy WebLinkAboutdrain layer permit 57 Sharon Drive �: TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL B/P No.:
South Windsor, Connecticut
List No.: _
DRAIN LAYER"S PERMIT ND 1201
"3/ , 19
Pursuant to written applic tior, permission ' eby granted the Licens Drain La er named herein to perform
the work in ated bel at2 V Y � 7 on the
ey side, (?/J /
at premises owned by jk 6,f6 6
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 (/, INDUS AL W BYES ( ), OR ( )
Connection will be made with
42
Permit to be issued to /
the holder of Drain Layer's License No.&/V P rmit will expire on
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
Connection Charge Paid Licensed Drain Lay r
Issued by
Tax Collector _
Permit Nee: Paid $ _�� ' /o 0
INSPECTION: Check Number: �U C 0
INITIAL �. /Gd�a Jam` L:. (Sig)
FINAL (Sig)
APPROVED nn -1- (Date)
(Sig)
INSPECTO
N e c?-.3 '
NOTES SOUTH WINDSOR POLL ION C NTROL
LOCATION
OWNER
TYPE OF WORK 'o
DATE -1- 2 2 PERMIT 20 PIPE
-- --- -- - _ ----INSTALLER
INSPECTOR 6RAWN BY
TOWN OF SOUTH WINDSOR
TOWN HALL
.SOUTH WINDSOR, CONN. 06074
DEPARTMENT POLLUTION CONTROL
Date . . . . : . . . . . . . . . .
The Sanitary Sewer . . . :: . . . Septic System . . . . . . . . . .
at . . . . . . . . . . . . . . . . . .
or lot #. . . . . . . . . . . . . . . has been installed and completed
in accordance with the Town of South Windsor ordinances
and regulations.
Accepted and Approved
By Date