HomeMy WebLinkAboutDrain Layers Permit 706 Misty Meadow Lan TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL
B/P No.:
South Windsor,Connecticut
List No.: _
DRAIN LAYER'S PERMIT NO 3076
19�_
Pursuant to written a plicatior, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at A� b on the
side, be ween 4P i��j aLt�
at premises owned by
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 1�rain 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
1 y- �.3 Signea
Connection Charge Paid 4 Licensed Drain Layer
Issued by
T� Collector Permit Fee: Paid $
INSPECTION: Check Number:
t
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
INSPECTOR (Sig)