HomeMy WebLinkAboutDrain Layers Permit 252 Fairview Drive TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL
South Windsor, Connecticut B/P No..
List No.. _
DRAIN LAYER'S PERMIT Np 2666
Pursuant to written appl�catior permission ion is hereby gr ted to the Lice se Drain La er named rein to perform
L 2 �f L .� y
1 f a-:: •
the work indicated'below at 411A •
•on the
., side. between
at premises owned by r
whose address is t
and to Lay'House`Drata;` Repa H 'D
ir ouserain; " La Main, Other
_ ' ,y ..,.�_. ,
for -
+ occupancy or use,
with _ sue, : Family Units, with.
acres. ;
Type of Sewage to be connected under this permit: r s
SANITARY SEWAGE *f
j, INDUSTRIAL WASTES.{
_ _
Connection will be made with
Permit to-be_issued.to
- --
the holder of Drain Layer's License No. Permit will expire on - 19
The undersigned Drain Layer liereby 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
/b
Signed
Connection Charge Paid Licensed Drain-Layer
^` Issued by
Tax Collector
_Y Permit Fee: Paid $ �
INSPECTION: Check Number: 1C�
INITIAL (Sig) G
FINAL (Sig)
APPROVED (Date)
(Sig)
INSPECTOR