HomeMy WebLinkAboutDrain Layers Permit 07 Case Hill Circle TOWN OF SOUTH WINDSOR
DEPARTMENT OF POLLUTION CONTROL
_
South Windsor, Connecticut B/P No.:
List No.: _
DRAIN LAYER'S PERMIT N? 3049
Pursuant to written ap licat/Iior,1permsion is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at C r ( k _ on the
side, between
at premises owned
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 excavation.
SPECIAL CONDITIONS
y (c Signed onnection Charge Paid U p J' /�j Licensed Drain Layer
I III
Issued by
� T Collector
Permit Fee: Paid $
INSPECTION: Check Number:
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
INSPECTOR (Sig)
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