HomeMy WebLinkAboutDrain Layers Permit 207 Spring Meadow Dr TOWN OF SOUTH WINDSOR
DEPARTMENT OF POLLUTION CONTROL
B/P No.:
South Windsor, Connecticut
List No.: _
DRAIN LAYER'S PERMIT
O 2872
/Lj�— l , 19
Pursuant to written applicatior, permission is here y granted to�thhe, Licensed Drain Layer named herein to"perform
the work indicated below at -, on the
side, between b-
at premises"owned by tj
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
f� Signed
Co pection Charge Paid �j3 Licensed Drain Layer
Issued by
Tat)Collector nn
Permit Fee: Paid $
INSPECTION: Check Number:
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
INSPECTOR (Sig)