HomeMy WebLinkAboutDrain Layers Permit 75 Diane Drive (3) TOWN OF SOUTH WINDSOR
DEPARTMENT OF POLLUTION CONTROL
B/P No.:
South Windsor, Connecticut
List No.: _
DRAIN LAYER'S PERMIT N0 2676
/ Jy ( ' 19
Pursuant to written applicatior, ermission is h by granted to the Licensed Drain Layer named herein to perform
the work indicated'below at
on the
side;'betw en
at premises owned by-, It tiU (�
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 ( j, INDUSTRIAL 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 SPECIAL CONDITIONS
�i Signed , .
Connection Charge Plaid 7 Qd_y y Licensed Drain Layer
o�A
Issued by
Tax Collector
Permit Fee Paid $
INSPECTION: Check Number: 3 xU
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
INSPECTOR (Sig)