HomeMy WebLinkAboutDrain Layers Permit 808 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
O 3256
19
Pursuant to written ap 1'catior, permission is hereby granted to the Licensed Drain aver named herein to perform
the work indicated below at41,�J4on the
side, bet een
at premises owned by_ J"LA, ! �
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
jCoeetion Charge Paid Licensed Drain Layer
Issued by
Collect
Permit Fee:. Paid $
INSPECTION: Check Number:_
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
(Sig)
INSPECTOR