HomeMy WebLinkAboutDrain Layers Permit 35 Dawn Drive TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL
South Windsor, Connecticut B/P No.: ev
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List No.: _ -3
DRAIN LAYER'S PERMIT N? 2215
Pursuant to written appliic''atior, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at
an the
side, between
at premises owned by Q �� a r- '), U C
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
\l Connection Charge Paid -/� a� Licensed Drain Layer
4 4 U r lL�"� Issued by
Permit Fee: Paid $
INSPECTION: Check Number:
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
(Sig)
INSPECTOR
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