HomeMy WebLinkAboutDrain Layers Permit 210 Fairview Drive TOWN OF SOUTH WI N DSOR
j DEPARTMENT OF POLLUTION CONTROL B/P No.:
South Windsor, Connecticut List No.: _
DRAIN LAYER'S PERMIT N? 2691
Pursuant to written ap licatior, permission is hereby granted to the Licensed Drain Layer named herein to perform
/ l on the
ork indicated below at��� '%� �� �
side, between
at premises owned by
hose address is
and to Lay House Drain, Repair House Drain, Lay-Main; Other '
occupancy or use,
for
Family Units, with acres.
with -
Type of Sewage to be connected under this permit:
SANITARY SEWAGE ( ), INDUSTRIAL WASTES { ), OR ( , )
Connection will be made with
Permit to be issued to Permit will expire on 19
the holder of Drain Layer's License No.
.
all the and conditions set forth on the permit the reverse side
The undersigned Drain Layer hereby agrees to
thereof. Applicant has received Town Permit No.
and/or C H D Permit No.
for street excavation.
SPECIAL CONDITIONS
dc
Signed
Licensed Drain Layer
Connection Charge Paid ��d D(�
Issued by
Tax Collector
J Permit Fee:. Paid $
Check Number: Ln
INSPECTION: ,
- (Sig)
INITIAL
FINAL- (Sig)
(Sig)
- - -- L- - ------ —.--__- __�..---- --- --- _—---__- __�--Y
(Date)
APPROVED
(Sig)
INSPECTOR