HomeMy WebLinkAboutDrain Layers Permit 160 Edgewood Drive TOWN OF SOUTH WI N DSOR
.j DEPARTMENT OF POLLUTION CONTROL
B/P No.:
South Windsor, Connecticut
List.No.: _. 1_.
DRAIN LAYER'S PERMITO 2;036
19
Pursuant to written appliccatior, permission is hereby granted the.Licensed Drain Layer named herein to perform
the work indicated below at i tf on the
side, between
at premises�wned by
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
l
t
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
Connection Charge Paid '' �� ,Licensed Drain Layer
i
Issued by
Tax Collector
Permit Fee:. Paid _ ���_ %'0
INSPECTION: Check Number:
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
(Sig)
INSPECTOR
J C
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I
1
SG
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