HomeMy WebLinkAboutDrain Layers Permit 87 Dawn Drive TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL B/P No ` 1\
South Windsor, Connecticut
List No.: _
DRAIN LAYER'S PERMIT N? 2541
' 19
Pursuant to written a licatior, permission is ereby granted to the Lic used Drain Layer named herein to pe orm
the work indicated below at Yld-.f c) ` Q e (Zlt"-=^ Y �� on the
side, between 1
at premises owned by—
whose address is
and to Lay House Drain, Repair House Drain, Lay Main,; Other
i
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
F
3
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 s e
thereof. Applicant has received Town Permit No. and/or C H D Permit No.
for street excavation.
SPECIAL CONDITIONS
3
Signed
Connection Charge Paid 1 ,01) Licensed Drain Layer
(�ff ,
�L /LL!C. �GC G��� Issued by w
Tax Collector —
Q Permit Fee: Paid $ _�/�
INSPECTION: Check Number: = M& -
INITIAL (Sig)
a FINAI. (Sig)
VE j/ (Date)
nc3 (Sig)
ECtORt