HomeMy WebLinkAboutDrain Layers Permit 150 Diane Drive (2) _ TOWN SOUTH WI D
N SCR
DEPARTMENT OF POLLUTION CONTROL B/P No.:
South Windsor, Connecticut
List No,
DRAIN LAYER'S PERMIT
730
19_
Pursuant to written applicatior, permission is hereby granted to,the Licensed Drain Layer named herein to-perform
the work indicated below.at-,-,,& also
/ on the
} side,
mom
at premises owned by T
whose address is- I
and to Lay House Drain; Repair House Drain, Lay Main, Other
fort ,9cupancy or use,
with Family Units, with
Type of Sewage to be connected under this permit:
,t SANITARY SEWAGE (Xj, INDUSTRIAL WASTES '( ), OR
' "Connection will be milde with "
Permit to be issued to
the holder of Drain Layer's License No. Permit will expire—on' A!� 19_
The undersigned Drain Layei-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 ' L ensed Drain:Layer, „
. Issued by
Tax Collector
Permit Fee:. Paid _—
INSPECTION: Check Number:
INITIAL Ar a "" (Sig)
FINAL , ` (Sig)
APPROVED #t � �c - (Date)
.�. r (Sig)
)NSPECTOR