HomeMy WebLinkAboutDrain Layers Permit 05 Abar Lane TOWN f'.OFY SOUTH WIN DSO_ R _
DEPARTMENT OF POLLUTION CONTROL
B/P No.:
South Windsor, Connecticut
List No.. _
DRAIN LAYER'S PERMIT NO 2949
, 19 3
Pursuant to written applicatior, permission is hereby granted to the ceased Drain Layer named herein to perform
the work indicated below at �_.� on the
side, between
at premises owned by.,l
whose address is -'
and to - Lay House Drain, Repair House Drain, ' Lay Mam, Other
for occupancy or use,
with Family Units, with acres.
Type of Sewage to be connected under this permit:
SANITARY SEWAGE ( ), INDUSTRIAL WASTES (s ), OR ,( ) 4
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 HDlPermit No.
for street excavation.
SPECIAL CONDITIONS
Signed
Connection C)iaige Paid I'llZi Licensed Drain Layer
�• '�",,d 9�/�-'E't Issued by
.Tax Collector
V Permit Fee:. Paid $
INSPECTION: Check Number: 2 1!9
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)-.,.
INSPECTOR (Sig)