HomeMy WebLinkAboutDrain Layers Permit 678 Clark Street TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL
South Windsor, Connecticut B/P No.:
List No.:
DRAIN LAYER'S PERMITp. 552
8 ' 19 ?4 _
Pursuant to written applicatior, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at on the
&&lot side,_betwee P'tasaan,t Va3lex ad* ,
at premises owned by
whose address is
and to — ,_Lay House Drain, Repair House Drain, Lay Main, Other
for occupancy or use,
with Family.Units.,;1ewith acres.
Type of Sewage to be connected under this permit:
SANITARY SEWAGE (It", INDUSTRIAL WASTES .( ), OR ( )
Connection will.be made with 1geh p3 asti
Permit to be issued to * aw
the holder of Drain Layer's License No. Permit will expire on 19
The undersigned Drain Layer hereby aktees to all the t rms'an 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 Paid Licensed Drain Layer
Issued by
Tax Collector
Permit Fee:. Paid $
INSPECTION: Check Number: ,
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
INSPECTOR (Sig)