HomeMy WebLinkAboutDrain Layers Permit 150 Brook Street TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL gip No.:
South Windsor, Connecticut GJ3,
List.No.: _ �3
DRAIN LAYER'S PERMIT Np 1369
J2 --Z , 19 ? 7
Pursuant to written applicatior, permission ' hereby ranted to icensed Drain Layer named herein to perform
the work indicated be w at on the
side, betwe n
at premises owned by 00
whose address is
and to Lay House Drain, - Repair House in, Lay Main, Other
for occupancy or use,
with Family Units, with acres.
Type of Sewage to be connected under this permit:
SANITARY SEWAGE , INDUSTRIAL W STES
Connection will be made with y L/
Permit to be issued to
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
// Signed
Connection Charge Paid ��b Licensed Drain Layer
Issued by
Tax Collector
Permit Fee: Paid $ _
INSPECTION: Check Number: ,
INITIAL (Sig)
FINAL (Sig)
APPROVED �3G J (Date)
/'1"Clfj, �'c. (Sig)
INSPEC OR