HomeMy WebLinkAboutdrain layer permit 305 Sullivan Avenue TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL
B/P No.:
South Windsor, Connecticut
List No.:
DRAIN LAYER"S PERMIT NO 1242
- / � 19
Pursuant to written applicatior, permiss oo is hereby granted t he Licensed Drain Layer named herein to"perform
i the work ' icate low at oc� Qru/( o Q Y? C?
on the
6 [>�/ side, betty n
at premises owned by. ��
i
whose address is
and to ""4 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 (y, INDUSTRI4� WASTES ), OR ( )
Connection will be made with
I' Permit to be issued to
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
i
Signed ioccl
Connection Charge Paid Licensed Drain Lay
e
i- `^2 Z Issued by
Tax Collector
s
Permit Nee:. Paid $ _ J dU
INSPECTION: Check Number: Al
INITIAL (Sig)
FINAL (Sig)
APPROVED — (Date)
(Sig)
INSP TOR
r
i
- -- 7/
.0 -44
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NOTES -: SOUTH WINDSOR WLLUTION C ROL
LOCATION 30,5v
f , OWNER
TYPE OF WORK o 0,4 J.
f DATE - PERMIT/2 PIPE
INSTALLER kLcLj
/� INSPECTOR DRAWN BY
CI'
J
- - " -
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