HomeMy WebLinkAboutDrain Layers Permit 129 Fairview Drive } TOWN OF SOUTH WINDSOR
DEPARTMENT OF POLLUTION CONTROL
South Windsor, Connecticut B/P No.:
List No.: _
DRAIN LAYER'S PERMIT Np 2997
Pursuant to written applicatior, permission ' hereby gra d to the Licensed Drain Layer named,herein to perform
the work indicated below at �I 11 f at%1 J )
_ 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
the holder of Drain Layer's License No. Permit will expire on I
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 _ d b �j Signed
Licensed Drain Layer -
n X-C 11 for f Issued by
Permit Fee:. Paid 0 0
INSPECTION: Check Number:_
INITIAL_ _-
.-_---
FINAL
(Sig)
APPROVED
INSPECTOR (Sig)