HomeMy WebLinkAboutDrain Layers Permit 50 Alison Drive TOWN OF SOUTH W1 N DSOR
DEPARTMENT OF POLLUTION CONTROL
South Windsor, Connecticut B/P No.:
List No.: _
DRAIN LAYER'S PERMIT X? ' 2394
, 19 �
Pursuant to written applicatior, permission is hereby granted tote Licensed Drain Layer named herein to perform
the work indicated below at J(} i SO r
on the
side, between
at premises owned by
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
Permit to be issued to
the holder of Drain Layer's License No.
The undersigned Drain Layer hereby agrees to all the terms and con Permit will expire on 19
ditions set forth on the permit and the reverse side
thereof. Applicant has received Town Permit No.
for street excavation. and/or C H D Permit No.
SPECIAL CONDITIONS
{'O/ d I Signed
,Connection Charge Paid
�/(!G Licensed Drain Layer
Tax Collector Issued by
Permit Fee: Paid $ iS_=___
INSPECTION: Check Number: - /,�'fe.3
INITIAL (-Tip m-,-fcA // Tc-
(S.1 / _ J
FINAL (Si ) //�/��f�j ��U�'tC"1 h�
APPROVED (Date)
INSPECTOR (Sig) SCANNED'
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