HomeMy WebLinkAboutDrain Layers Permit 118 Country View Dri pa. _ .s,.,yrr•�sFF!'F.;KAI�`.-'-.-q�T'RIwY ..
TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL
South Windsor, Connecticut B/P No.:
List No.: _
DRAIN LAYER'S PERMIT O 2672
19
Pursuant to written applicatior, permiss'on is hereby granted to the Li ensed Drain 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. 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
Signed
Connection Charge Paid 0WO- Licensed Drain Layer
� Issued by
044afxCo�llect,r Permit Fee:. Paid $
INSPECTION: Check Number:
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
(Sig)
INSPECTOR