HomeMy WebLinkAboutDrain Layers Permit 97 Country View Driv TOWN OF SOUTH WINDSOR
DEPARTMENT OF POL
a South Windsor, C� TION CONTROL B/P No.:
}nnecticdt
List No.: _
DRAIN LAYER'S PERMIT N? 2764
Pursuant to written applicalltior, permission is hereby granted o the Licensed Drain Layer named herein to per
the work indicated below at on t
side, between
at premises owned by r l /2l
whose address is
and to Lay House Drain, Repair House Drain, Lay Main, Other '
for uses;;
occupancY or
with Family Units, with acres.
Type of Sewage to be connected under this permit: 5
SANITARY SEWAGE ( j, 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 —1
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
Signed
Connection Charge Paid /QQ .0 0 Licensed Drain Layer
Issued by
Tax Collector
Permit Fee: Paid $
INSPECTION: Check Number:
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
(Sig)
INSPECTOR