HomeMy WebLinkAboutDrain Layers Permit 32 Clinton Drive (2) TOWN OF H WINDSOR .
A..
DEPARTMENT OF POLLUTION CONTROL
B/P No.:
South Windsor, Cori ecticut
List.No.:
DRAIN LAYER'.S PERMIT
p 501
19
Pursuant to written applicatior, permission is hereby granted to the Licensed,Drain Layer'na'med herein to-perform
the work indicated;below at on the
Ana side, between :
at premises owned by
whose address is
and to �• Lay House Drain, Repair House Drain, Lay Main, Other
for Z �
occupancy or use,
with_-IftFamily Units, with acres.
Type of_Sewage to-be connected under;this permit;
SANITARY SEWAGE (X j, IN WASTES .(. ),'OIt
Connection will be made withsoft
Permit to be issued to
the holder of Drain Layer's I_.icense No. Permit will expire'on 19
The undersigned Drain Layer heteby 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, WNW
Signed
Connection Charge Paid I
Vicensred ra .Lay '
Tax Collector Issued by
Permit Fee: Paid $ -vow_
INSPECTION: Check Number:
INITIAL Sig
)
FINAL (Sig)
APPROVED , ate)
* INSPECTOR OR
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