HomeMy WebLinkAboutDrain Layers Permit 485 Foster Road TOWN OF SOUTH WI N DSOR
DEPARTMENT OP POLLUTION CONTROL
South Windsor, Connecticut B/P No.:
List No.: _ 3` 07(�,_
DRAIN LAYER'S PERMIT Np 2196
19 A
Pursuant to written applicatior, permission is hereby granted to t Licensed Drain Layer named herein to perform
the work indicated below at 0S� Jh'r ,
on the
side, between/� n
at premises owned by_ /O L//, le" 7�f
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 WASTES-( ), OR ( )
Connection will be made with
Permit,to be issued to
the holder of Drain Layer's License No. Permit will expire on 19
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
X�17S I11y1
.�- Signed
Connection Charge Paid �y C/'j/n�[� Licensed Drain Layer
Issued by -
-Tax Collector
l 1.0
Permit Fee:. Paid $
INSPECTION: Check Number:
INITIAL
FINAL (Sig)
- APPROVED _
(Sig)
INSPECTOR _ _ - - -