HomeMy WebLinkAboutDrain Layers Permit 47 Evergreen Lane TOWN OF SOUTH WINDSOR
DEPARTMENT OF POLLUTION CONTROL
South Windsor, Connecticut B/P No.:
List No.. _ 3 / 9 7/
DRAIN LAYER'S PERMIT p 2091
�17 Eveh �, >� , 190
Pursuant to written appli at�permission is hereby granted to the Licensed Drain La er named
r Y herein to perform
the work indicated below at V�_ 0 C Vte(G(-t'e✓1
on the
side, between
at premises owned 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
Permit to be issued to
the holder of Drain Layer's License No._ aC) p
�P !�• 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.
for street excavation. and/or C H D Permit No.
SPECIAL CONDITIONS
�
Connection Charge Paid y(70 Signed Licensed rain Layer
Tax Collector Issued by
0
Permit Fee:. Paid $
INSPECTION: Check Number:
INITIAL
_.._---_ _--- --- (Sig)_
FINAL (Sig)
APPROVED
(-Date) _----
INSPECTOR (Sig)