HomeMy WebLinkAboutDrain Layers Permit 33 Brewster Road x�. f vWN of SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL
South Windsor, Connecticut B/P No:; --
List No.: c� 3
DRAIN LAYER'S PERMIT
Pursuant to written applicatior, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work.indicated below at
on the
_40016—side, between_
at premises owned by {
whose address is
and to XKLay.House Drain, Repair House Drain, La Main, Other
for
occupancy or use,
with Family Units, with
acres.
Type of Sewage to be connected under this permit:
SANITARY SEWAGE O, INDUSTRIAL WASTES _( ), OR ( )
Connection will be made with } boom
i
Permit to be issued to obubut
the holder of Drain Layer's License No. "` Permit will expire on 19
75 .
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 Charge Paid . Licensed Drain Layer
Tax Collector
Issued`by frIN
Permit Fee: Paid $ _
INSPECTION: Check Number:
INITIAL
(Sig)
FINAL (Sig)
s APPROVED (Date)
j (Sig)
INSPECTOR