HomeMy WebLinkAboutDrain Layers Permit 33 Alexander Place TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL SCANONED
South Windsor, Connecticut
List No.: _
DRAIN LAYER'S PERMIT - O 3380
19 g
Pursuant to written ap licatJior pI'ef ris io is herebyg,(rj janted oD the Licensed Drain Layer named herein to perform
the work indicated below ate ,� 1 {� ► 1(/i✓1�/�Jl �C�2_ 33 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,
s- with Family Units, with acres.
.r; 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
Signed
C nnection Charge Pai# Q6. 0 d Licensed Drain Layer
rIssued by
T ' Collecto � > _
Permit Fee: Paid $
INSPECTION: Check Number: V��
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
(Sig)
INSPECTOR