HomeMy WebLinkAboutDrain Layers Permit 1004 Misty Meadow La TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL
South Windsor, Connecticut B/P No.:
List No.: _
DRAIN LAYER'S PERMITO 3330
V �-O 19
Pursuant to written.ap licatior, permission is hereby granted to the Licensed Drain Layer named herein to perform
tj
the work indicated below at / :j on the
side, b een U
at premises owned by % S
whose address is
E"
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
E
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
- �&3 U
Signed
onnection Charge Paid#00 Q Licensed Drain Layer
Issued by
as Coll t r
a S/ Permit Fee: Paid $ _ mod.0
r INSPECTION: Check Number:
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
(Sig)
INSPECTOR
s_ A