HomeMy WebLinkAboutDrain Layers Permit 199 Bourbon Street TOWN OF SOUTH WINDSOR
DEPARTMENT OF POLLUTION CONTROL
B/P No.:
South Windsor, Connecticut
List No.: _
DRAIN LAYER'S PERMIT lr0 3282
J 194f (10
Pursuant to written applic)atiioor, permission is he by granted to the Licensed Drain Layer named herein to"perform
the work indicated below at GlJ'� / 1 /( IC�C�
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.
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
Signed
Connection C 'e Paid CZ S L��'� Licensed Drain Layer
�&/t4/F44� Issued by
Tax Collector J L
Permit Fee: Paid $
INSPECTION: Check Number: Y—o
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
INSPECTOR (Sig)