HomeMy WebLinkAboutDrain Layers Permit 019 Cadbury Lane ,. ..,, .....,.. . ate...
TOWN OF SOUTH WINDSOR
DEPARTMENT OF POLLUTION CONTROL
B/P No.:
South Windsor, Connecticut
List No.: _
DRAIN LAYER'S PERMIT N0 3032
Pursuant to written a7catior' , permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below atT iE ` on the
side, between'
at premises owned byl::I
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
Connection Charge Pail ZlOf), G O Licensed Drain Layer
Issued by
" Tax Collector
Permit Fee:. Paid $
INSPECTION: Check Number:
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
(Sig)
INSPECTOR