HomeMy WebLinkAboutdrain layer permit 489 Sullivan Avenue TOWN OF SOUTH WINDSOR
DEPARTMENT OF POLLUTION CONTROL B/P No.:
Ekl it t/O i'j five- South Windsor, Connecticut
d � rnerl °� DRAIN LAYER'S PERMIT -
N° 1386
ve ,r�
A �lT2 t$ , 19—;7;0
Pursuant to written application, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below atTXi _ �ce�Lt�A�C.t�,O ����5`/moo/�—a . on the
side, between — £
at premises owned by
whose address is f�
and to Lay House Dtain,( � epair 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 (✓ecj, INDUSTRIAL WASTES .( ), OR ( )
Connection will be made with
Permit to be issued to
the holder of Drain Layer's License No. Q . .Permit will expire on 19
The undersigned Drain Layer hereby agrees to all the ferms 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 // Licens Drain Layer
Issued by
Tax elector
Permit Fee:. Paid $
INSPECTION: Check Number:
INITIAL (Sig)
FINAL (Sig)
APPROVED �—Z%' (Date)
I
(Sig)
INSPECTOR
i
2 `Pee p P✓YE
c 2e�
8
1 o0
i
i
97. 5
NOTES A4 EA S, F SOUTH WINDSOR POLLUTION CONTROL
/�- w y E s LOCATION C_t rd
OWNER Z /WV/c,
TYPE OF WORK
DATE PERMIT PIPE
INSTALLER -
INSPECTOR DRAWN BY