HomeMy WebLinkAboutDrain Layers Permit 007 Andreis Trail (3) TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL Bhp No.:
/ South Windsor, Connecticut
List No.: _
{ DRAIN LAYER'S PERMITS 3353
k
19 Jy
Pursuant to written applica/tior�permission is hereby granted to the Licensed Drain Layer named erein to perform
the work indicated below at
on the
side, between
at premises owned by VIN
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. 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
Connection ge Paii/d (jj/ Licensed'Drain Layer
Issued by
ax Collector
� Permit Fee:. Paid $,(J
INSPECTION: Check Number:
INITIAL
, qPgANNEDFINAL.
APPROVED (Date)
(Sig)
INSPECTOR