HomeMy WebLinkAboutdrain layer permit 75 Mark Drive (2) TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL
B/P No.:
South Windsor, Connecticut �-7
List No.: _
DRAIN LAYER'S PERMIT NO 1423
UNE Z 6 , 19 .74S
Pursuant to written application,,, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at 5 MaRz Ali?11/� on the
side, between
at premises owned by W-�e
whose address is
and to Lay House Drain, Repair House Drain, Lay-Main, Other
for T-14.L- occupancy or use,
with Q/1/� Family Units,,with acres.
Type of Sewage to be connected under this permit:
SANITARY SEWAGE (x), INDUSTRIAL WASTES .( ), OR ( )
w
Connection will be made with G e V
Permit to be issued to_ Amm )/1/1"s-NTe:"
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
Signed
Connection Charge Paid -ol q Licensed Drain Layer
Issued by
Tax Collector
Permit Fee:. Paid $ _ o
INSPECTION: Check Number: = [D _
INITIAL (Sig)
FINAL (Sig)
APPROVED e-�J� (Date)
(Sig)
INS ECTOR
N y5° Lend Two y5°Bens
6.5
WYE
0.0. I
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Lu
Q
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I
Lafera I I
NOTES SOUTH WINDSOR POLLUTION CONTROL
LOCATION 96 Mark Or'ive-
OWNER Colby
TYPE OF WORK
DATE 6-26 -�8 PERMIT I q 23 PIPE 6" P VC-
INSTALLER
INSPECTOR a.—I urel, DRAWN BY
SCa�e QG SV ow r�