HomeMy WebLinkAboutDrain Layers Permit 55 Brewster Road TOWN OF SOUTH 3 '
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DEPARTMENT OF POLLUTION CONTROL
B/P N : N�
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( Y � South Windsor, Connecticut
t List.No. .
.....� . . � .,. .►. ,. .. DRAIN LAYER'S -PERMIT � 639
F
19
Pursuant to written applicatior, permission is hereby granted to the Licensed Drain Layer named herein to"perform
the work indicated below at . ft � on the
-- side, between MW _ '
at premises owned by
whose address is
and to s Lay House Drain, Repair House Drain, Lay.Main, Other
for r'. t . occupancy or use,
with eno f� Family Units, with - acres.
Type,of Sewage to be connected under this permit:
SANITARY SEWAGE G ), INDUSTRIAL WASTES :( . ), OR
Connection will be made with NE1 # A* r
mot
Permit to be issued to
the holder of Drain Layer's License No. � Permit will expire on 19
The undersigned Drain Lacer hereby agreesxto all the terms and co ns set forth on the permit and the reverse side
thereof:= Applicant.bps rec ived Town Peftit No. and/or C HD Permit No., .
for street excavation.
SPECIAL CONDITIO
` Signe °
Connection Charge Paid 3 t ie d Drain layer
Issued by 04ft
Tax Collector' ;.
�> Permit Fee:.-Paid $
` INSPECTION: Check Number:
INITIAL Si
FINAL i. (Sig)
APPROVED ,+• '' _A (Date)
tj
- IN9$EktOR ,-.
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