HomeMy WebLinkAboutDrain Layers Permit 29 Dart Hill Road TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL B/P No.:
South Windsor, Connecticut
List.No.:DRAIN LAYER'S LAYER',S PERMIT N? 1656
Pursuant to written applicatior, permission is hereby granted to thf Licensed Drain L er named herein to perform
the work indicated belo at on the
t
side, between
f
at premises owned by
whose address is
and to _/,::::�fLay House Drain, Repair House Drain, Lay Main, Other ,
for —occupancy or use,
withxramily Units, with acres.
Type of Sewage to be connected under this permit: "?z�� .r
SANITARY SEWAGE ( —,INDUSTRIAL WASTES OR ( )
Connection will be made with (� f r P.
Permit to be issued to Aair/'
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
Signedt-
Connection Charge Paid / Licensed Drai Layer
Issued by
Tax Collector
Permit Fee Paid $ r
INSPECTION: Check Number:
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
(Sig)
INSPECTOR