HomeMy WebLinkAboutDrain Layers Permit 61 Country View Driv TOWN OF SOUTH WINDSOR
DEPARTMENT OF POLLUTION CONTROL
B/P No.:
South Windsor, Connecticut
List No.: _
DRAIN LAYER'S PERMIT O 2763
Pursuant to written applicatior, permission is hereby granted to�the icensed Drain Layer named herein to perform
the work indicated below at ` on the
side, between
at In
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
a 9d¢3
Signed
Connection Charge Paid -000•p U Licensed Drain Layer
i
---�,.L bgAu,D Q17 11-4A Issued by
Tax Collector
Permit Fee:. Paid $ _ �19V_
INSPECTION: Check Number:
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
(Sig)
INSPECTOR