HomeMy WebLinkAboutDrain Layers Permit 61 Case Hill Circle TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL gip No.:
South Windsor, Connecticut
List No.: _
DRAIN LAYER'S PERMIT 3335
7 , 19
Pursuant to written applicatior, ermission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at at on the
side, between
at premises owned by1C
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 Sexcavation.
SPECIAL CONDITIONS
-a7-d
Signed
Connection Charge Pa Qd-D 0 Licensed Drain Layer
Issued by
Tax Collector
Permit Fee: Paid $
¢ ` INSPECTION: Check Number:
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
(Sig)
INSPECTOR