HomeMy WebLinkAboutDrain Layers Permit 059 Ash Road TOWN OF SOUTH WI N DSOR
r DEPARTMENT OF POLLUTION CONTROL f ,
B/P No.:
South Windsor, Connecticut
List.No.: _
DRAIN LAYER'S,PERMIT N 641
19
Purst}ant to written applicatior, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at ti 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 io`be connected.under this permit:
SANITARY SEWAGE ( j., I-NDUSTRIAt WASTES .( ),'OR
Connection will be made with
Permit to be issued to AOft raft
the holder of Draia lAyer's License No._ M f Permit will expire on 19
The undersigned Drain Layer hereby agrees to all the terms and conditions set forth on the permit an the reverse side
thereof. Applicant has received Town Permit No. and/or C H D Permit No..
for street excavation.
SPECIAL. CONDITIONS ;_
Signed
Connection Charge Paid Licensed Drain Layer
Issued by _ 94
Tax Collector
Permit Fee:.:Paid I _
INSPECTION: Check- Number,
INITIAL a'" (Sig).
FINAL (Sig)
;' APPROVED (Date)
' _{' .; (Sig)
INSPECTOR