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HomeMy WebLinkAboutDrain Layers Permit 147 Gail Lane TOWN OF SOUTH WI N DSOR DEPARTMENT OF POLLUTION CONTROL B/P No.: South Windsor, Connecticut List No.: _ DRAIN LAYER'S PERMIT N? 2390 Qu, 19 cj�/ Pursuant to written applicatior, permissio is here granted to the Licensed Drain Layer named herein to perform the work indicated below at �`h �� �� �� on the side, between at premises owned by 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 ( j, 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 HD Permit No. for street excavation. SPECIAL CONDITIONS -rt Signed Connection Charge Paid b U Licensed-Drain Layer Issue by - - --- ,Tpx Collector �/ Permit Fee: Paid $ _ U _ _ __==---- -- -----iNS BG•FI41I :- Checlt-- umbar - - INITIAL --- - — - — (Sig) FINAL (Sig) -- APPROVED (Date) — -- -- - -(Sig) - - INSPECTOR