HomeMy WebLinkAboutDrain Layers Permit 100 Cadbury Lane TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL B/P No.:
South Windsor, Connecticut
List.No.: _
DRAIN LAYER'S PERMIT N0 3250
d� , 19 OLq
Pursuant to written agplicatior permiss'on is ereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at L] D 00 on the
side, between
at premises owned byl '- M
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
L�.�3. 1 Signea
Co icri Charge Paid b .,.,�p Licensed Drain Layer
Issued by
lector n /x
4' Permit Fee: Paid $ _ ,00
._
INSPECTION: Check Number:
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
(Sig)
INSPECTOR