HomeMy WebLinkAboutDrain Layers Permit 51 Bourbon Street TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL
South Windsor, Connecticut B/P No.:
List No.: _
DRAIN LAYER'S PERMITp 3285
Pursuant to written appliccatiioor, permission i hereby g
the work indicated below at
to a Licensed Drain Layer named herein to perform
Z /
on the
side, betwe PP
at premises owned
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
ConnecConnect!*! Signeu rge Paid S Z Licensed Drain Layer
Issued by
'Tax Collector
Permit Fee: Paid $ S L
INSPECTION: Check Number:
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
INSPECTOR (Sig)