HomeMy WebLinkAboutDrain Layers Permit 5 Evergreen Lane w TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL
South Windsor, Connecticut B/P No.:
List No.:
DRAIN LAYER'S PERMIT - -
N° 1546
Pursuant to written applicatio perm si
p hereby granted to the Licensed Drain Layer name erform
the work indicated below at
on the
side, between
at premises owned
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 .Ll �/.f' (.'l
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
Signed
Connection Charge Paid Licensed Drain Layer
Issued by
Tax Collector
Permit Fee:. Paid $
INSPECTION: Check Number: O
INITIAL (Sig)
FINAL (Sig)
_ APPROVED (Date) '
(Sig)
INSPECTOR
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