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HomeMy WebLinkAboutDrain Layers Permit 325 Diane Drive TOWN OF SOUTH WI N DSOR DEPARTMENT OF POLLUTION CONTROL South Windsor,'Connecticut B/P No.: List No.: _ DRAIN LAYER'S PERMIT O 2510 19 cF Pursuant to written applicatior, permission is hereb ranted to the Licensed Drain Layer named herein to perform the work indicated below ata /( on the side, between e n at premises owned by -De>� _ � �lX /L 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 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 �Z Signed Connection barge Paid " / L- Licensed Drain Layer Issued by Tax Collector Permit Nee: Paid INSPECTION: Check Number: - a 5 3tb INITIAL (Sig) FINAL (Sig) APPROVED (Date) .. (Sig) INSPECTOR