HomeMy WebLinkAboutDrain Layers Permit 88 Dawn Drive ,. TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL B/P No.:
South Windsor, Connecticut
List No.:
DRAIN LAYER'S PERMIT N? 2396
19 0`11/
Pursuant to written appli eeatiior,��p//ermissio is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below atd��- 7� _ /xA,l ,� 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
f Signed
Connection Charge Paid Q Licensed Drain Layer
Issued by
Tax CoIlect
' Permit Fee:. Paid $
INSPECTION: Check Number:
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
(Sig)
INSPECTOR
N -
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NOTES SOUTH WZNDSOR POLLUTION C01UROL
LOCATION '
TYPE OF WOiE
DATE r` ..f t PERMIT23 9 PIPE L1
INSTALLER
INSPECTOR DRAWN BY `�