HomeMy WebLinkAboutDrain Layers Permit 65 Diane Drive (2) TOWN OF STIR WI N DSOR
DEPARTMENT OF POLLUTION XONTROL
B/P No.:
South Windsor,Connecticut
List No.:
DRAIN LAYER'S PERMITp 613
, 19
Pursuant to written application, permission is hereby"granted to,the-"Licensed Drain Layer named herein to perform
the work indicated below at on the
side, between
at Premises owned
whose address is'
and to Lay House Drain, Repair House Drain, Lay-Main, Other
for 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 MIK
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 t ie terms and conditions set forth on tl ...ri and_the reverse
thereof. Applicant has received Town Permit No. and/or C H D Permit No.
for street excavation.
SPECIAL CONDITIONS-406
Signed
Connection Charge Pai , Licensed Drain'Layer
Issued by A.. .:— � .•.rw,r�
Tax Collector
Permit Fee:. Paid __
INSPECTION: Check Number:
INITIAL 41 ;'I. '= (Sig)
FINAL (Sig)
APPROVED � , s," (Date)
(Sig)
INSPECTOR'.