HomeMy WebLinkAboutDrain Layers Permit 165 Dogwood Lane 1
TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL
B/P No.: _
South Windsor, Connecticut
List No.: _
DRAIN LAYER'S PERMIT N0 2443
19�L—
Pursuant to written application, permission is er y granted to the Licensed Drain Layer named herein to perform
the work indicated below at on the
si e, bet een �n
at premises owned byi1
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. 12 O(0 9/0 Permit will expire on /U 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
Iq
Signed
Connection Charge Paid Licensed Drain Layer
�f��(22?L1�__ Issued by -��•`_<� 7-%-�` � r�_
�, Tax Collector
"-� `�' Permit Fee: Paid $
INSPECTION: Check Number:
INITIAL I L (Sig)
FINAL (Sig)
APPROVED (Date)
(Sig)
INSPECTOR