HomeMy WebLinkAboutDrain Layers Permit 200 Bourbon Street _ .. , _ _.. -n ,. A;'1.^rxc,.c f :.+:r,;::...aPi�7S,�F 's�.aj�:'7�yCC,•�•�.�6rc�, aL4�y1'��'� _i� .u, t'
TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL
��(� B/P No.:
South Windsor, Connecticut
4N List No.: _
DRAIN LAYER'S PERMIT No 3259
S 3 , 19 y
Pursuant to written appl'ca ' r*rmissssi n is heresy g�a
__ nted o the Licensed Drain Layer named herein to perform
the work indicated below at Y V,(� AAA b - )T 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 gverse side
�..,.
thereof. Applicant has received Town Permit No. and/or C H D Permit No.
for street excavation.
SPECIAL CONDITIONS
Signed
Connectio rge Paid 'j�dY/ �� ?el Licensed Drain Layer
Issued by
-Tax Collector
Permit Fee:. Paid $
3
INSPECTION: Check Number: 1
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
(Sig)
INSPECTOR