HomeMy WebLinkAboutDisconnection 59 Deepwood Drive £t
TOWN OF SOUTH WI NDSOR
i.
DEPARTMENT OF`POLLUTION CONTROL Bhp No.:
South Windsor, Connecticut
List.No.:
-�*- DRAIN LAYER'S PERMIT d
• 647
' 19
ursuant to written app icator, permission is hereby granted to the Licensed Drain'Layer named herein to perform
the work indicated.below at
on the
t +.
side,.between
at premises owned byVNIFEW
f x whose address is
and to . -Lay House Drain, Repair House Drain, Lay Main, Other_ ,
for �. .� occupancy.or use,
with .Family Units, with ,acres.
f Sewage to.be connected under this permit;
SANITARY,SEWAGE O, INOUSTRIAL WASTES
Connection will made withOW ! ..
' Permit to be issued to All SWIM
'
s the holder of Drain Layet's License No. Permit will expire on 19 .
The;nndersigned Drain Layer hereby agrees to all the terms'and conditions set forth on the permit and the reverse side x
u f
"thereof. Applicant has received Town Permit No. and/or C H D Permit No.
for street excavation.
SPECIAL CONDITIONS.`-•
Signed ;r •-�' _ »:zr�r. -r
Connection Charge.Paid _ Li ensed Drain Layer
1�
Issued by
Tax Collector
Permit Pee:. Paid _
INSPECTION: Check Number:
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
(Sig)
INSPECTOR