HomeMy WebLinkAboutDrain Layers Permit 699 Deming Street TOWN OF SOUTH WINDSOR
DEPARTMENT OF POLLUTION CONTROL
B/P No.:
{ South Windsor, Connecticut
List No.: _
DRAIN LAYER'S PERMIT NO 2660
19
Pursuant to written applicatior, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at +I r� ;':O on the
side, between
at premises owned by ' ' L ' �
whose.address is
and to Lay Mouse Drain, Repair House Diain, Lay Main, Other
for
occupancy or use,
with Family Units, with acres.
Type of Sewage to be connected under this Ipermit:
SANITARY SEWAGE { j, INDUSTRIA 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
Connection Charge Paid ,L/0U•n Licensed Drain Layer
- ki ' hU�kiu Issued by
- Tax Collector
Permit Fee: Paid $ _ Uv
INSPECTION: Check Number:
INITIAL (Sig)
FINAL (Sig)
. APPROVED (Date)
INSPECTOR (Sig)