HomeMy WebLinkAboutDrain Layers Permit 115 Diane Drive TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL BAP No.:
South Windsor, Connecticut
List No.: _
DRAIN LAYER'S PERMIT O 3403
z3
, 19 C
Pursuant to written applicatiior, er sion is hereb granted to the Licensed Drain Layer, named herein to perform
the work indicated below at // /l.C�-'� '� on the
side, betwe
at premises owned by
whose address is
and to Lay House Drain, Repair House Drain, Lay Main, Other
6 for occupancy or use,
with Family Units, with acres.
Type of Sewage to be connected under this permit:
E
SANITARY SEWAGE ( �, INDITSTRIAL 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
�y Signed
Connec ' harge Paid I'lect Q Z Licensed Drain Layer
Issued by
Tax Collector J
Permit Fee: Paid $ ry>
INSPECTION: Check Number: Q
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
(Sig)
INSPECTOR.