HomeMy WebLinkAboutDrain Layers Permit 56 Brewster Road (2) ' TOWW4 OF SOUTH WI N DSOR {
DEPARTMENT OF POLLUTION CONTROL i
South Windsor, Connecticut
SSA'. S- GjQ:•.
DRAIN LAYER'S PERMIT N0. 269
QJA R ' 19
'Pursuant to written application, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at +, on the
side, between
at,premises owned by
whose address is
and to +Lay House Drain, Repair House Drain, Lay Main, Other ,
for x occupancy or use,
with :` .Family Units, with acres.
Type of Sewage to be connected under this permit:
SANITARY SEWAG , 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 : r.
The undersigned Drain Layer hereby agrees to all the terms and conditions set forth on the permit and the reverse side
thereof. Appiicant has received Town Permit No. and/or C H D Permit No.
for street excavation.
SPECIAL CONDITIONS
Signed
Connection Charge Paid $ Licensed Drain Layer
(Sig) Issued by i.
Tax Collector
Permit Fee: Paid $,f
INSPECTION: =; ..,. ...,..
INITIAL (Sig)
FINAL (Sig)
APPROVED-1 4 :Z I (Date)
(Sig)
' I�NbPECTOR