HomeMy WebLinkAboutDrain Layers Permit 6 Country View Drive TOWN OF SOUTH WINDSOR
DEPARTMENT OF POLLUTION CONTROL BAP No.:
South Windsor, Connecticut
List No.: _
DRAIN LAYER'S PERMIT
O 2538
19 Z-
Pursuant to written applicatior, permission is hereby granted to the Licensed Dr in Layer named herein to perform
the work indicated below at1 on the
side, between 1�
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 ( j, INDUSTRIAL WASTES .( ), OR ( )
Connection will be made with
Permit to be issued to,
theholder of Drain Layer's License No. : Permit will expire on 19
The undersigned Drain Layer 4ereby 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
�—` Signed .
Connectio arge Paid �/ 4 s ��A �_ Licensed Drain Layer
i
Issued by
Tax Collector //
Permit Fee:. Paid $ 1i 77 a
INSPECTION: Check Number:
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
INSPECTOR (Sig)