HomeMy WebLinkAboutDrain Layers Permit 090 Bayberry Trail TOWN OF SOUTH WINDSOR
DEPARTMENT OF POLLUTION CONTROL
B/P No.:
South Windsor, Connecticut /`Z-7�'-
List.No.: _(�
DRAIN LAYER',S PERMIT N? 1324
J s , 197
Pursuant to written applicat' r, per��n is her y grantecj�to the Licensed Drain ayer named herein to perform
the work in 'cared ow at ,✓Gj on the
side, between
--6/ 4!�z
at premises owned by
whose address is
and to K 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 ASTE OR
Connection will be made with_ �� G % '�-�
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.
PECIAL CO ITION
c/ lIv l /70
Signed ,
Connection Charge Paid Licensed Drain Layer
Issued by
Tax Collector
Permit Fee:. Paid $
INSPECTION: Check Number:
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
(Sig)
INSPECTOR