HomeMy WebLinkAboutDrain Layers Permit 116 Edgewood Drive TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL B/P No..
South Windsor, Connecticut
List No.: _
DRAIN LAYER"S PER NO 1993
Pursuant to written applicatior, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at ,/7rd- Z)/( on the
side, between
at premises owned by—
whose address is
and to -Lay House Drain, Repair House Drain, Lay-Main, Other
for "! �.� 5� occupancy or use,
with /Family Units, with acres.
Type of Sewage to be connected under this permit:
SANITARY SEWAGE (INDUSTRI
IAAL WASTES ( ), OR ( )
Connection will be made with l CJ �—
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
Signe
Connectio arge Paid �/(jv / f Licensed Drain"Layer
Issued by
Tax Collector
Permit Fee:. Paid $
INSPECTION: Check Number: c�Z-7
INITIAL (Sig)
FINAL (Sig)
APPROVED Z� (Date)
(Sig)
INSPECTOR