HomeMy WebLinkAboutDrain Layers Permit 48 Blue Ridge Drive ` TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL
South Windsor, Connecticut B/P No..
List No.: (0
DRAIN LAYER'S PERMIT NO 2056
S /y , 19 K
Pursuant to written applicatior, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at - ilk
on the
side, between
at premises owned by 13P—(-�6-1 �6
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 ( j, INDUSTRIAL WASTES .( ), OR ( )
Connection will be made with
fi
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 condit4s 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 Charge Paid C C License rain Layer
Issued by
Tax Collector ? ,
Permit Fee Paid $ / DU �' R
INSPECTION: Check Number.
INITIAL �^ 15 (Sig)
^- /
,tee g)
FINAL (Sig) Xy
APPROVED (Date)
(Sig)
INSPECTOR