HomeMy WebLinkAboutDrain Layers Permit 129 Country View Dri TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL
South Windsor, Connecticut B/P No.:
List No.: _
DRAIN LAYER'S PERMIT NO 2605
/ ,
Pursuant to written appl cati r, perm ion is hereby granted to he Licenseedydd Drain Layer named herein to perform
the work indicated below at v��Ci- "-t/ 02 on the
side; between
at premises owned by_
whose address is
and to Lay House Drain, Repair House brain, 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
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
Connection Charge Paid 11471
— f z Signed Licensed Drain Layer
Issued by
Tax Collector
Permit Fee: Paid $
INSPECTION: Check Number:
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
(Sig)
INSPECTOR