HomeMy WebLinkAboutDrain Layers Permit 21 Brewster Road (2) TOWN OF `SOUTH � WlNDSOR
DEPARTMENT OF PQ_..LUTV'N CONTROL
South Windsor, Connecticut B/P No.:
List No:
DRAIN LAYER15 PERMIT
508
19'
Pursuant to written applicatior, permission is hereby granted to the.Licensed Drain Layer named he to e
the work indicated.below ah . # j► - p rform
side, between �� �N,r....._ �-__� ,
on the
at premises owned by
whose address is
and to X _Lay House Drain,for: Repair House Drain,
Lay Main;: Other
with Oiiiir occupancy or use,
Family Units, with
Type of,,Sewage acres.
ewage to be connected under this permit:
SANITARY SEWAGE ( j; INDUSTRIAL WASTES OR
.( '
Connection will be made with
Permit to he issued to
the holder of Drain Layer's License No
The undersigned Drain Layer hereby agrees to all the•term's and c ire on J"q-
onditions Permit set illforth on he Permit and the reverse side thereof. I Applicant has received Town Permit No.
for street excavation. and/or C H D Permit No.
:.
SPECIAL CONDITIONS
Signed: f .. jz
Connection Charge Paid y t _
Licensed Drain Layer
Tag Collector Issued by' %I* A. s MAU.- e
Permit Fee:. Paid $ _ !
INSPECTION: Check Number:
INITIAL
-,(Sig)
FINAL — �
(Sig)
APPROVED s ...,, .,, ,.. s }
(Date)
"` INSPECTOR (Sig)