HomeMy WebLinkAboutDrain Layers Permit 498 Buckland Road TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL
B
South Windsor, Connecticut Li/P No.:
st No.: IS 7 4-
DRAIN LAYER'S PERMIT NO 1612
Pursuant to written applicatior, permission is hereb anted the L' ensed Drain Layer named herein to-"perform
the work indicated below at
on the
side, between
at premises owned by
whose address is CY Q
and to y Lay House Drain, Repair House Drain, Lay Main, Other
for 1-01
occupancy or use,
with Qp Family Units, with acres.
Type of Sewage to be connected under this permit:
62
SANITARY SEWAGE 4,`)j-, INDUSTRIAL WAS,TEES ( ), OR ( )
Connection will be made with (� /
Permit to be issued to
1 the holder of Drain Layer's License No. ?-0 A Permit will expire on Itl
The undersigned Drain Layer hereby agrees to al the termsan and conditions set forth on the permit the reverse side
/ thereof. Applicant has received Town Permit No. and/or C H D Permit No.
for street excavation.
SPEC CONDITIONS
Signed
Connection Charge Paid - Z Licensed Drain Layer
Issued by
Tax Collector
Permit Fee:. Paid $ _
INSPECTION: Check Number:
INITIAL (Sig)
FINAL (Sig)
APPROVED r-2 — (Date)
(Sig)
INSPECTOR