HomeMy WebLinkAboutDrain Layers Permit 245 Diane Drive r
TOWN OF SOUTH WINDSOR
DEPARTMENT OF POLLUTION CONTROL
B/P No.:
South Windsor, Connecticut
List No.: _
DRAIN LAYER'S PERMIT N? 2737
19
Pursuant to written applicatior, permission is hereb ranted to the Licensed Dr ' L m ayer named herein to perfor
the work indicated below at c � ' on the
side, between (�
at premises owned by—
whose address is
and to Lay House Drain, Repair House Drain, Lay Main, Other
for o �'"y� occupancy or use,
with Family Units, with acres.
Type of Sewage to be connected under this permit:
SANITARY SEWAGE ( ), INDUSTRIAL WAS '( ), OR ( )
Connection will a made with !/ C
Permit to be issued to 1(/
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 Char Paid Qz /7i � 1- v Licensed Drain Layer
Issued by
T x Collector /
Permit Fee: Paid $
INSPECTION: Check Number: S
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
(Sig)
INSPECTOR