HomeMy WebLinkAboutDrain Layers Permit 184 Fairview Drive TOWN OF SOUTH WINDSOR
DEPARTMENT OF POLLUTION CONTROL
South Windsor, Connecticut B/P No.:
List No.: _
DRAIN LAYER'S PERMIT 2569
1!� , i9Z-
Pursuant to written applicatior, permission ireby granted to t1K,,Licensed Drain Layer named herein to perform
the work indicated below at � / I � `�r�
on the
side, between
at premises owned by
whose address is
and to Lay House Drain, Repair House Drain; La Main
Y' 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 1 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
!U 0 L L Signed
Connection Char id Licensed Drain Layer
T ol ax
Issued by
lector
Permit Fee: Paid $ k L
INSPECTION: Check Number: 0?s/—
- INITIAL _-.. _. -
- __ __ _ ___ _. . -(Sig) - _
- - _ - FINAL (Sig)
A 0YED - -
ate -- ---
INSPECTOR (Sig)