HomeMy WebLinkAboutDrain Layers Permit 465 Buckland Road TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL BAP No.:
South Windsor, Connecticut
List No.: _
DRAIN LAYER'S PERMIT NO 3066
IQovi"A" ) 6 , 19
Pursuant to written applicatior, permission is hereby ranted to the 'censed D in La name erein to perform
the work indicated below at� ^'£ v`
on the
side, between
at premises owned bye Q ny, �d To /1 ar
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
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
Sig
4ection Charge Paid p�U_(� a 7&3Issued by
Collector
Permit Fee: Paid $ _�`'• �_D
INSPECTION: Check Number:
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
(Sig)
INSPECTOR
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