HomeMy WebLinkAboutDrain Layers Permit 18 Alison Drive n
TOWN OF SOUTH WINDSOR
DEPARTMENT OF POLLUTION CONTROL gip No.:
South Windsor, Connecticut
List No.: _
DRAIN LAYER'S PERMIT O 3385
19 jr
Pursuant_to written applicatior, permission is her bb granted to the Licensed Drain Layer named herein to perform
the work indicated below at i 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
` r
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
Connect' arge Paid Licensed Drain Layer
1 Issued by
Tax Collector
Permit Fee:. Paid $
INSPECTION: Check Number: Z
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
(Si"INSPECTOR I ;ANNEU