HomeMy WebLinkAboutDrain Layers Permit 419 Buckland Road TOWN' 0 SOJTH WI N bSOR
DEPARTMENT OF- POLLUTION CONTROL
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South Windsor, Connecticut
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DRAIN LAYERS PERMIT
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Pursuant to;written application, permission is hereby granted to the Licensed Drain Layer named'herein to;perform
'the.work indicated below,at +#` (""A on the
K401A side,`between
soft
' at premises owned by
whose address is
and'`to ALL4y House Drain, Repair House Drain, Lay Main,:: Other
for occ�}p ncy or use,
with Family Units, With acres. • :
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Type of Sewage to be connected under this permit,.
SANITARY SEWAGE, XK INDUSTRIALVAS-TEES.,-.0RI.
Connection will be made
M1. ;
111111*411116 tot)
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Kermit to"-be issued to r
{'F E the holder of Drain Layer's License No. Permit will expire on 19`
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The undersigned Drain Layer hereby agrees to all the:terms and conditions scat forth.on the pern it and the reverse side'
'Y` flie;eof. Applicant has -received Town Permit No. and/or C H D Permit No.
for street excavation.
* SPECIAL CONDITIONS
Signed A4z arw =ate / "�..a,
Connection Charge.Paid g Licensed DralgLa�yer44
(Sig) Issued by.
Tag Collectorid
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INSPECTION:
INITIAL] (dig) i
v
FINAL`. ••"' '" ; (Sig)
A> PROVED •. (Date)
{ (Sig)
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-JNS'P•EETOR