HomeMy WebLinkAboutdrain layer permit 59 Sullivan Avenue TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL
South Windsor, Connecticut B/P No.:
List No.:
DRAIN LAYER'S PERMIT NO 1589
19
Pursuant to written applicatior, permi sion is ereby granted to the Licensed Drain Layer named herein to perform
i
the work indicated below at S on the
side, between
e
I /
{ at premises owned by
1 whose address is
y
and to —zLay House Drain, Repair House Drain, Lay Main, Other
for occupancy or use,
with 6l Family Units, with acres
Type of Sewage to be connected under this permit-.
SANITARY SEWAGE ( jam),/INDUSTRIAL WASTES ( ), OR ( )
Connection will be made with
Permit to be issued to
the holder of Drain Layer's License No. Zo 6 7r Permit will expire on /D •— D / 19
The undersigned Drain Layer hereby agrees to all the terms and conditions set forth on the permit and the re verse sidde
thereof. Applicant has received Town Permit No. and/or C H D Permit No.
for street excavation.
SPECIAL C NDIT NS O
30
Signed
11aA-. 1A)t 10,/. J,%
Connection Charge Paid 0 Q ,Licensed rain Layer
A rq
Issued by
Tax Collector r
4z���
Permit Fee: Paid $ —z-S'i_—etv _
INSPECTION: Check Number: ,
INITIAL (Sig)
\ FINAL (Sig)
( \ APPROVED Z, (Date)
(Sig)
INSPECTOR
ge
--M-4
PAO p iv cW c T S�
r � c
NOTES SOUTH WINDSOR POLLUTION CONTROL
LOCATION
OWNER
TYPE OF WORK 4-
DATE PERMIT PIPE A
INSTALLER
INSPECTOR WN BY