HomeMy WebLinkAboutDrain Layers Permit 172 Fairview Drive TOWN OF SOUTH WINDSOR
DEPARTMENT OF POLLUTION CONTROL
South Windsor, Connecticut B/P No.:
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List No.: _
DRAIN LAYER'S PERMIT Np 2504
' 1 � , 192
Pursuant to written a licatior
P , per fission is hereby ranted o the Licensed Drain Layer named herein to perform
the work indicated below at
on the
side, between
* at premises owned by
whose address is
and to Lay House Drain, Repair House Drain,
Lay-Main, Other
i� for
with occupancy or use,
Family Units, with
1
Type of Sewage to Ike connected under this permit: acres.
SANITARY SEWAGE ( ), INDUSTRIAL WASTES :( ), OR
Connection will be made with
Permit to be issued to
the holder of Drain Layer's License No. Permit expire on
The undersigned Drain Layer hereby agrees to all the terms and cond'tions s tlforth_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
C eR Ciarge Paid �, Signed
Licensed Drain Layer
\ ax Collect Issued by
\ l
Permit Fee:. Paid $
INSPECTION: Check Nunlberj
&
INITIAL �'
FINAL
(Sig)
APPROVED
INSPECTOR (Sig)