HomeMy WebLinkAboutDrain Layers Permit 805 Misty Meadow Lan TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL B/P No.: _
South Windsor, Connecticut
List.No.: _
DRAIN LAYER',S PER M 3079
ll - iv , 19
Pursuant to written a p icatior, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at o— --- on the
side, beAween94, Ui
at premises owned byh/ 5
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 ( j, 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
ct M y Signed
Connection Charge Paid lI- �3 Licensed Drain Layer
PJ'I U�-C Issued by
_T c Collects ( �
�''^" Permit Nee:. Paid $ _
INSPECTION: Check Number:
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
(Sig)
INSPECTOR