HomeMy WebLinkAboutDrain Layers Permit 202 Abbe Road r TOWN OF SOUTH WINDSOR
r
DEPARTMENT OF POLLUTION CONTROL BAP No.:
South Windsor, Connecticut
List No.: _
DRAIN LAYER'S PERMIT 2330
19
Pursuant to written applics9atior, permission i hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below atP'uiba
on the
side, between
at premises owned
whose address is
and to 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 ( ), INDUSTRIAL WASTES ( ), OR
Connection will be made with
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
�.l
Signed
Connection Charge Paid A _fi 0 Licensed Drain Layer
Issued by
Tax Collector
Permit Fee: Paid $
INSPECTION: Check Number: `%�%�'%
6
s ; f
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
INSPECTOR
(Sig)
r
r'
N _ -
NOTES SOUTH WINDSOR POLLUTION CONTROL
LOCATION O�}
i OWNER , A.0
TYPE OF WORK i S Po ee ra
DATE -g -Ft PERMIT =30 PIPE
INSTALLER a o n s l
INSPECTOR DRAWN BY