HomeMy WebLinkAboutDrain Layers Permit 260 Brookfield Stree TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL Bhp No.: _
South Windsor,Connecticut
List No.: _
DRAIN LAYER'S PERMIT N? 2709
19 � .
Pursuant to written applic/a-tion, permission is hereb graft d to the. Licensed Drain Layer named herein to perform
the work indicated below at
on the
side, between
T-
at premises owned by /y!P/!�/ teat t'11litA
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 SEWAGE ( ), 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
T►he 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 L1U0.0 U Licensed Drain Layer
Issued by
Tax Collector
Permit Fee:. Paid $
INSPECTION: Check Number:
INITIAL (Sig)
FINAL , (Sig)
APPROVED (Date)
INSPECTOR (Sig)
i