HomeMy WebLinkAboutDrain Layers Permit 36 Evergreen Lane TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL
B/P No.:
South Windsor, Connecticut -3�
List No.: _ /
DRAIN LAYER'S PERMIT N? 2079
19
Pursuant to written applicatior, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at 407�. ay? �vP�S/�C
on the
side, between
at premises owned CG1(/a—
whose address is
q and to Lay House Drain, Repair House Drain, Lay-Main, Other
\ for '
\ occupancy or use,
ith Family Units, with acres.
Type of Sewage to be connected under this permit:
SANITARY SEWAGE ( j, INDUSTRIAL WASTES .( ), OR ( )
Connection will be made with
Permit to be issued to
the holder of Drain Layer's License No. o?O G��`7 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
Signed ��iz
Connection Charge Paid Oo —� L1censs 17ram Layer
Issued by
Tax Collector
Permit Fee:. Paid $ _� OO
INSPECTION: Check Number: o?3ly/O
INITIAL a`�Cc
Sig) _ - -
FINAL (Sig)
t1PRROVEIL— —
Y
(Sig)
INSPECTOR