HomeMy WebLinkAboutDrain Layers Permit 514 Felt Road (2) DEPI��TME.NT -OF`POLLUTION CONTROL
B/P No.:
South Windsor, Connecticut �.
.List,No.: "
f DRAIN LAYER'-S PERMIT
O 725
, 19
uisuant to wntten appIicatior, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at ��' rug on the
004 side, between
at premises owned by VA
whose address is saw
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 WASTES ( ), OR
Connection will be mve with ) 14�0 4 UtW4 " v
Permit to be issued to
the holder of Drain Layer's License No. Permit will expire on 19. A
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
a
Signed
Connection Charge Paid ,` Licensed Drain Layer
Issued by ` 'le
Tax Collector
Permit Fee Paid $
INSPECTION: Check Number:
INITIAL (Sig)
FINAL (Sig)
APPROVED 61ofkyo#004 (Date)
F r (Sig)
INSPECTOR