HomeMy WebLinkAboutDrain Layers Permit 67 Brewster Road (2) �
TOWN OF SOUTH WI N DSOR --"f:
DEPARTMENT' OF POLLUTION CONTROL
South Windsor, Connecticut
DRAIN LAYER'S PERMIT NO 282
iY.. , 19
Pursuant to written application, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below ate# on the
Yet side, between 06A 61n 06r.A
at premises owned by
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:
SANITARY SEWAGI) 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 A 19
The undersigned Drain Layer hereby agrees to all the terms and conditions set forth on the permit n the reverse sid
thereof. Applicant has received Town Permit No. and/or C H D Permit No.
for street excavation.
SPECIAL CONDITIONS MIM >
Signed
Connection Charge Paid� p Licensed Drain Layer
(Sig) Issued by
Tax Collector
Permit Fee: Paid $
INSPECTION:
INITIAL (Sig)
FINAL (Sig)
APPROVED JL±Kt 973 (Date)
C . .1 t (Sig)
INSPECTOR