HomeMy WebLinkAboutDrain Layers Permit 50 Country View Driv TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL
B/P No.: _
South Windsor, Connecticut
List No.: _
DRAIN LAYER'S PERMIT
'O 2675
Pursuant to written ap lic tior, p/e�rmssion is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below,at r-r / on the
r ..
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 ( j, INDUSTRIAL WASTES OR ( )
Connection will be made with
F,
Permit to be issue&to
the holder of Drain Layer's Licensg 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
dj
,^� Signeu
Connection Charge Paid ��� U� Licensed Drain Layer
Issued by
Tax Collector
Permit Fee: Paid $ / �d
INSPECTION: Check Number:
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
(Sig)
INSPECTOR