HomeMy WebLinkAboutDrain Layers Permit Building 11, Bryrewo TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL
B/P No.:
South Windsor, Connecticut f
List No.: _
DRAIN LAYER'S PERMIT N0 2261
19
Pursuant to written applicatior,permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below ate/ l on the
side, between
at premises owned by -G` tclii
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
:d
thereof. Applicant has received Town Permit No. and/or C H D Permit No.
for street excavation.
SPECIAL CONDITIONS
Signed
Connectio arge Paid L dZ1/�/ e/ Licensed Drain Layer
Issued by
Tax Collector
cZ
Permit Fee:. Paid $
INSPECTION: Check Number: 7, 3
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
(Sig)
INSPECTOR