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HomeMy WebLinkAboutDrain Layers Permit 95 Gail Lane TOWN OF SOUTH WI N DSOR DEPARTMENT OF POLLUTION CONTROL B/P No.: South Windsor, Connecticut List No.. _ DRAIN LAYER'S PERMIT ? 2946 7 , 19F..3 Pursuant to written applic>atioorr, permission is.hereby granted o the Licensed�nDr in Layer named herein to perform the work indicated below at on the side,,between at premises owned 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 H D Permit No. for street excavation. SPECIAL CONDITIONS Signed Connection Charge Paid 3 Licensed Drain Layer - Issued by Permit Fee: Paid $ ----- -- =PCTION-_ - - _Check Number - _ MIC (Sig) FINAL (Sig) (Date) (Sig) - - - --- - — _ INSPECTOR