HomeMy WebLinkAboutDrain Layers Permit 70 Breezy Hill Road TOWN OF SOUTH WINDSOR
DEPARTMENT OF POLLUTION CONTROL
South Windsor, Connecticut B/P No.: _
List No.: _ a`��b
DRAIN LAYER'S PERMIT 2140
Ifs 19 _
Pursuant to written applicatior, permission is hereby ranted to the
/Licensed Drain Layer named herein to perform
the work indicated below at 8(PPZ�1 r�� dC
on the
side, between
at premises owned by—, / f
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: r
SANITARY SEWAGE ( ), INDUSTRIAL WASTES .( ), OR ( )
Connection will be made with
Permit to be issued to y
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
Signeu
diL,f,✓t
Co necEtionl Charge Paid �/��.. Lice ed rain Layer
Tax CeU Issued'by
eeeer
Permit Fee: Paid $
INSPECTION: Check Number:
INITIAL (Sig)
FINAL O P
(Sig) OV ✓1
APPROVED (Date)
INSPECTOR (Sig)
i
i
5
71
411H
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e} P ri C7
SOUTH WINOSUP P0i_I_,UTR"-N C'ONTRO`
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INS
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