HomeMy WebLinkAboutDrain Layers Permit 305 Diane Drive (2) .. .
VOW
OWN OF SIOUI i 41 N DSOR y s
DEPARTMENT OF P.OLLUT1014` ONTROL
South Windsor, Connecticut
DRAIN LAYER'S PERMIT O 232
19
Pursuant tR written application! permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at , on the
at premises owned by
whose address is_
and to X 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 SEWAC,E 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 CONDITIONS pope 40" 11 %ft"U some
Signed I,P
Connection Charge Paid VXWVWW7d7 Licensed Drain Layer
(Sig) Issued by
R _
Tax Collector
Permit Fee: Paid
INSPECTION:
INITIAL (Sig) -
FINAL (Sig)
APPROVED NWO (Date)
ftv,10 111' :, ; (Sig)
} f JNSPEC `<
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