HomeMy WebLinkAboutDrain Layers Permit 06 Abar Lane TOWN OF SOUTH WINDSOR
DEPARTMENT OF POLLUTION CONTROL
South Windsor, Connecticut B/P No.:
List No.. _
DRAIN LAYER'S PERMIT N? 2950
Pursuant to written applicatior permission is hereb granted to a Licensed Drain Layer named herein to perform
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the work indicated below at :-,/ on the
side, between -/
at premises owned by � nc 4 -s(/
whose address is and to Lay House Drain, Repair House Drain, ?lay Main, Other
. .
for _ t occupancy or use,
with Family Units,_with acres.
Type of Sewage to be connected under this permit:
SANITARY SEWAGE ( j, INDUSTRIAL WASTES OR ( )
Connection will be made with - -
Permit to be issued to _
the holder of Drain Layer's License No. r 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. 3
for street excavation. ,
SPECIAL CONDITIONS -
Signed
Connection Charge Paid J(,'� Licensed Drain Layer
J` �1 Issued by
,Tax Collector J Permit Fee: Paid $ h1k
INSPECTION: Check Number: -z"
INITIAL (Sig)
FINAL (Sig)
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INSg�ECTOR 4 y_ ' -
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