HomeMy WebLinkAboutDrain Layers Permit Spring Meadow Drive TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL
B/P No.:
South Windsor,Connecticut
List No.: _
DRAIN LAYER'S PERMIT 'N? 2922
, 19e'3
Pursuant to written appl'catior per fission is hereby gr nted to the icens Drain yet nam. d llhe�ein to perform
the work indicated below at D l.C) `Y�L ,V S on the
side, between �-�
at premises owned by s 0 U
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
Signed
Connection Charge Paid Q . j- 3 Licensed Drain Layer
Issued by
J,Ta Co1J;ectof)
Permit Fee: Paid $ 00
INSPECTION: Check Number:
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
(Sig)
INSPECTOR