HomeMy WebLinkAboutDrain Layers Permit 90 Diane Drive TOWN OF SOUTH WINDSOR
DEPARTMENT OF POLLUTION CONTROL
B/P No.: _
South Windsor, Connecticut
List No.: S 6 0 7 15 Z-
DRAIN LAYER'S PERMIT O 841
19
Pursuant to written applicatior, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at Ane Ir'iv
on the
side, between
at premises owned
whose address is
andto Lay House Drain, Repair House Drain, Lay Main, Other
for 41-5 <i<;at1 L__
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 ;_= - %^ r
J,' I-r ti
Permit to be issued to
the holder of Drain Layer's License No. _+-9 ` 6,0 10 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 77 6
Licensed Drain Layer
- Issued by
Tax Collector
Permit Fee: Paid $
INSPECTION: Check Number: is t/
12 eG
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
(Sig)
INSPECTOR