HomeMy WebLinkAboutDrain Layers Permit 26 Country View Driv TOWN OF SOUTH Wi N DSOR
DEPARTMENT OF POLLUTION CONTROL B/P No.:
South Windsor, Connecticut
List No.: _
l
DRAIN LAYER'S PERMIT NO 2840
' 19�
Pursuant to written a licatiior, permissi is here y granted to the Licensed rain Layer named herein to perform
the work indicated below at I-C> T c� *9(10 on the
side, b (�en
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 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
v2� J Signed
onnection Charge Paid d. a 0 13/ Licensed Drain Layer
Issued by
a Eollect0
lea V��t Permit Fee:. Paid
L
INSPECTION: Check Number. g
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
(Sig)
INSPECTOR