HomeMy WebLinkAboutDrain Layers Permit 51 Gail Lane TOWN OF SOUTH WINDSOR
DEPARTMENT OF POLLUTION CONTROL B/P No.: _
South Windsor, Connecticut
List No.:
DRAIN LAYER'S PERMIT NO 2469
, 19�'/
51
Pursuant to written applicgti � permission is hereby,granted to the icensed Drain Layer.named herein to perform
G .
the work indicated below at � % i� - --"�� on the
side, between
at premises owned by— 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.
SPECIA ONDITIONS
1
�� fit✓ / Signed
Connectio ge Paid GEC! %b Z<`r�� j Lic gsed Drain Layer
Issued by '�'
ax Collector /
\ Permit Fee: Paid $
INSPECTION: Check Number:
INITIAL (Sig)
FINAL (Sig)
-- .APPROVED (Date) -
� ( ( (Sig)
INSPECTOR