HomeMy WebLinkAboutDrain Layers Permit 155 Deming Street TOWN OF SOUTH WINDSOR
DEPARTMENT OF POLLUTION CONTROL
South Windsor, Connecticut B/P No.:
List No.: _
DRAIN LAYER'S PERMIT
p 23$$
Pursuant to written applicatior, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at Jr.S yV1 J n S� • /
��C /t 10S C-� on the
side, between
at premises owned by
whose address is
and to Lay House Drain, Repair House Drain,
• Lay-Main, Other
for
with
occupancy or use,
Family Units, with z
acres:
Type of Sewage to be connected under this permit:
SANITARY SEWAGE ( ), INDUSTRIAL WASTES .( ), OR ( )
Connection will be made with
i
Permit to be issued to
the holder of Drain Layer's License No. Permit will expire on 1
The undersigned Drain Layer hereby agrees to all the terms and conditions set forth h on e permit and the reverse side
thereof. Applicant has received Town Permit No. •
for street excavation. and/or G H D Permit No.
SPECIAL CONDITIONS
the ,`a�y S5Xale c,-10Conr.
Connection Charge Paid i/00 Signed
Licensed Drain Layer
Tag Collector Issued by
Permit Pee:. Paid $
INSPECTION: Check Number:
INITIAL (Sig)
FINAL
(Sig)
APPROVED (Date)
INSPECTOR (Sig)
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