HomeMy WebLinkAboutdrain layer permit 51 Sharon Drive TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL B/P No.:
South Windsor, Connecticut
List.No.: _ C�
DRAIN LAYER"S PERMIT �O 1200
Pursuant to written applica ior, permissio i here y gran �the Licensed Drain Layer named herein to perform
the work ind' red below at / on the
d side, between. �b 7
at premises owned by--
whose address is
and to X—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
the holder of Drain Layer's License No. - 59��Permit will expire on le 1•— 19 77
The undersigned Drain Layer hereby agrees to all the terms and conditions set forth on the permit ad the reverse side
thereof. Applicant has received Town Permit No. and/or C H D Permit No.
for street excavation.
SPECIAL CONDITIONS
4
Signed
Connection Charge Paid Licensed Drain ayer
Issued by
Tax Collector
Permit Fee: Paid $
INS�P+E�CTION: Check Number: , —Z- K2
INITIAL � �� Ci>'�1 f`� (Sig)
FINAL (Sig)
APPROVED 3 3/ (Date)
(Sig)
INSPECTOR
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NOTES SOUTH WINDSOR POLLUTI N CONTROL
LOCATION// / r r.
OWNER
TYPE OF WORK ko .
DATE - - PERMIT Zoo PIPE
INSTALLER
INSPECTOR ECLJ DRAWK BY
TOWN OF SOUTH WINDSOR.
TOWN HALL
SOUTH WINDSOR, CONN. 06074
DEPARTMENT POLLUTION CONTROL
Date �.3�-7 77. . . . . . .
The Sanitary Sewer . . . . . Septic System .
or lot #. . . . ./ . . . . . . . . has been installed and completed
in accordance with the.Town of South Windsor ordinances
and regulations.
Accepted d Approved
Ey
Date 3