HomeMy WebLinkAboutdrain layer permit 1024 Sullivan Avenue TOWN of SOUTH WI N DSOR
j DEPARTMENT OF POLLUTION CONTROL `q
B/P No.:
South Windsor, Connecticut
List No.:
DRAIN LAYER'S PERMIT NO 1940
2-g , 19
Pursuant to written applicatior, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at on the
side, between
at premises owned by
whose address is
and to Lay House Drain, Repair House Drain, Lay-Main, Other
for ��,('!_ occupancy or use,
with CrytA?—Family Units, with acres.
r
Type of Sewage to be connected under this permit:
SANITARY SEWAGE ( INDUSTRIAL WASTES ( OR
Connection ( )
Connection will be made with
Permit to be issued to
the holder of Drain Layer.'s icense No. Permit will expire on 19
The undersigned Drain Ly#ygr 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
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/ OO �d 7"'
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Connectro Charge Paid Signed
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is s Drain Layer
Issued by /
Tax Collector tl a�S-7f f
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Permit Fee: Paid $
INSPECTION: Check Number: , S3-�
INITIAL (Sig) A//
FINAL (Sig)
APPROVED 7 (Date)
(Sig)
Y INSPECT-OR
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NOTES SOUTH WINDSOR POLLUTION CONTROL
D
E"S� LOCATION '
OWNER
TYPE OF WORK S
DATE fil3oO MRIT PIPE 'l
o INSTAL R
♦� "`? INSPECTOR DRAWN BY