HomeMy WebLinkAboutDrain Layers Permit 224 Fairview Drive TOWN OF SOUTH WINDSOR
DEPARTMENT OF POLLUTION CONTROL
South Windsor, Connecticut B/P No.:
List No.: _
DRAIN LAYER'S PERMIT p 2775
Pursuant to written appl'cattior,,/permission is ereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at 'y7ry �
on the
side, between
at premises owned by 4L 1i
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 WAS _( ), 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
Conne y ction Charge Paid ����. Signed
— � Licensed Drain Layer
-
Issued by
J Tax Collector
7� Permit Fee: Paid $
INSPECTION: Check Number:
INITIAL a ✓� ? x
(Sig)
FINAL
.(Sig)
APPROVED
INSPECTOR (Sig)