HomeMy WebLinkAboutDrain Layers Permit 166 Bourbon Street TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL
South Windsor, Connecticut B/P No.:
List No.: _
DRAIN LAYER'S PERMITp 336
19
Pursuant to written appli ti/or, permissi is hereby grante/d�o the Licensed Drain Layer named herein to perform
the work indicated below at ILap 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.
r Type of Sewage to be,connected under this permit:
SANITARY SEWAGE ( j, 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,
SPECt 1. CONDITIONS
Signed
Connection Charge 1 U Licensed Drain Layer
Issued b
Tag Coll6'ctor y
Permit Fee: Paid $
INSPECTION: Check Number:
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
(Sig)
INSPECTOR