HomeMy WebLinkAboutDrain Layers Permit 82 Country View Driv TOWN` OF SOUTH Wt N DSOR
DEPARTMENT OF POLLUTION CONTROL
B/P No.:
South Windsor, Connecticut
List No.: _
DRAIN LAYER'S PERMIT NO 2606
902 19 � z
Pursuant to written applicatior, permission is hereby granted to the �icensedJdDrrain Layer named herein to perform
the work indicated below at on the
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 ( ', ,INDUSTRIAL WASTES OR ( )
Connection will be made with
Permit to be-,issued to
the holder of Drain,Layer's License No. a Permit will expire on 19
The undersigned Drain Layer hereby agrees to al 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
Connection Charge Paid_ �� t Licensed Drain Layer
Issued by
ax Col ector G
Permit Fee: Paid $
INSPECTION: Check Number:
INITIAL (Sig)
i
FINAL (Sig)
APPROVED (Date)
(Sig)
INSPECTOR