HomeMy WebLinkAboutDrain Layers Permit Clark Street - Main TOWN OF SOUTH WINDSOR
DEPARTMENT OF POLLUTION CONTROL
B/P No.:
South Windsor, Connecticut
List No.: _
DRAIN LAYER'.S PERMIT O 3478
' 19fi`�
Pursuant to written appliccat/Jior, permissio is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at on the
side, between
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, 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 1
The undersigned Drain Layer hereby agrees to all the terms and conditions set forth on the permit and the reverse sideL'
thereof. Applicant has received Town Permit No. and/or C H D Permit No.
for street excavation.
SPECIAL CONDITIONS
r
Signed
Connection Charge Paid Licensed Drain Layer
z7/(,. Issued by
k t Tax Collector
Permit Fee: Paid $
INSPECTION: Check Number:
L- �1ti }tv
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
(Sig)
INSPECTOR