HomeMy WebLinkAboutDrain Layers Permit 12 Betty Drive TOWN OF SOUTH WINDSOR -
DEPARTMENT OF POLLUTION CONTROL
South Windsor,Connecticut B/P No.: _
List No.:
DRAIN LAYER'S PERMIT 2945
/i3 19 � 3
Pursuant to written applicatior, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at
on the
side, between_- A I
at premises owned by
whose address is
� and to —Lay House n
H Drain,
Repair House Drain, Lay plain, Other
✓ for
with occupancy or use,
' 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 e on 1
The undersigned Drain Layer hereby agrees co all the terms and conditions set forth�on flie permit and the reverse side
thereof. Applicant has received Town Permit No.
for street excavation. and/or C H D Permit No.
SPECIAL CONDITIONS
Connection C Signed
Paid j Licensed Drain Layer
Ta Collector Issued by
Permit Fee: Paid $
INSPECTION: Check Number:
INITIAL
(Sig)
FINAL
(Sig)
APPROVED (Date)
INSPECTOR (Sig)