HomeMy WebLinkAboutDrain Layers Permit 416 Abbe Road (2) TOWN OF SOUTH 'WI N DSOR
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DEPARTMENT OF POLLUTION CONTROL B/P No.:
South Windsor, Connecticut
List No.: 6 1 6 (0 O
DRAIN LAYER'S PERMIT NO i699
�J19 7T
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_ Jw r cl !•1 i o d �k
whose address 's
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 f.VC,
Permit to be issued to cc w 0.'" d Alt C A a, 1 S k/, 0 kn POW n P
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 io 0.�er A0,1 � b� �J E f,i-d►^/�'1 e�
Oe,n cuck L'yr LDS �- �r"4ddocl�
►" E'c`�'r�' C0.S t to e Q
rr it r�
Signed '
Connection Charge Paid 4 h1censecTDrain Layer
Issued by
Tax Collector
Q U
Permit Nee: Paid $
INSPECTION: Check Number: S
INITIAL (Sig)
07,
p
FINAL Si )
APPROVED (Dates ra
C' .1
(Si�J
INSPECTOR
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NOTES SOUTH WINDSOR POLLUTION CONTROL
LOCATION
OWNER
TYPE OF WORK
DATE PERMIT PIPE ,
INSTA LE ,y w="
INSPECTOR _ / RAWN BY PC"
SCANNED