HomeMy WebLinkAboutDrain Layers Permit 17 Brookfield Street (2) TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL B/P No.:
South Windsor, Connecticut ^S �`
List No.:
DRAIN LAYER' S PERMIT N? 2448
Pursuant to written appli�c7atior, permission is/fhereb ranted to the Licensed Drain Layer named herein to perform
the work indicated below at / � L�U on the
side, betweob
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 SEWAGE (d j, 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
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. X
CIAL CONDITIONS 4z
16�-,90 6( Signed
Connection Charge Paid Q Q Q Licensed Drain Layer
e Issued by
- Tax Collector
Permit Fee: Paid $ Z67dd
INSPECTION: Check Number:
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
(Sig)
INSPECTOR