HomeMy WebLinkAboutDrain Layers Permit 21 Dawn Drive TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL gip No.:
South Windsor, Connecticut
List No.:
DRAIN LAYER'S PERMIT N? 2046
' 19
Pursuant to written applicatior, permissi/on is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at of j�/.AI P4WV) —�)r on the
side, between //��
at premises owned by- J )n J A-P S —Tnc
whose address is
and to Lay House Drain, Repair House Drain, Lay-Main, Other ,
for occupancy or use,
with amily 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
f
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
00 Signed
Connection Charge Paid yDD ice d D in Lay
�S7s 101o"All
Issued by
Tax Collector �j
Permit Fee: aid $
INSPECTION: Check Number:
INITIAL (Sig) J mT
FINAL (Sig)
APPROVED — (Date)
(Sig)
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INSPE TOR ,,