HomeMy WebLinkAboutdrain layer permit 66 Sharon Drive TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL B/P No.:
South Windsor, Connecticut f "
List.No.:
DRAIN LAYER'S PERMIT XO 1203
3_' '? , 19Z
Pursuant to written appli atior, pe i;ssigd is herb gract►��o the Licensed Drain Layer named herein to perform
the work in; cca'ted bglo at on the
/f/� I! side,4er*een
at premises owned by '
whose address is
and to —XLay 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 (�, INDUSTRI L 77SJ( ) OR ( )
Connection will be made with
Permit to be issued to
the holder of Drain Layer's License No. W-9? Permit will expire on- 19?
The undersigned Drain Layer hereby, agrees to all the terms an conditions set forth on the permit and the verse sidde
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 yer
- Issued by
Tax Collector _
Permit Fee Paid $ _ �s �� O CD
INSPECTION: Check Number:
INITIAL / / ,� •1� (Sig)
f,
FINAL (Sig)
APPROVED h
- 7 7 (Date)
(Sig)
INSPECTOR
(• a 4.
Vz
NOTES SOUTH WINDSOR POLLUTION CONTROL
LOCATION Q,vn
OWNER
TYPE OF WORK
DATE -/-7 PERMIT Zo PIPE ; wv,t
INSTALLER vPri
INSPECTOR G DRAWN BY
F TOWN OF SOUTH WINDSOR
TOWN HALL
SOUTH WINDSOR, CONN. 06074
DEPARTMENT POLLUTION CONTROL
Date . . . . .`T �`�"�•�.�. . . . . . .
The Sanitary Sewer . . a. . . Septic System . . . . . ...
at
K.14 . .
or lot •.• • • • • has been installed and completed
in accordance with the Town of South Windsor ordinances
and regulations.
Accepted Approved
—27
By G`' Date /���