HomeMy WebLinkAboutDrain Layers Permit 105 Gail Lane TOWN OF SOUTH WINDSOR
DEPARTMENT OF POLLUTION CONTROL
B/P No.:
South Windsor, Connecticut
List No.: _
DRAIN LAYER'S PERMIT NO 2 5$
t0 19
Pursuant to written applcator, petiqson is hereby grant o e Licensed Drain Layer named herein to perform
the work indicated below at l Q I b on the
side, bete
at premises owned by S t/l),
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:
SANITRY SEWAGE{ ), INDUSTRIAL WASTES:.(. ), OR ( )
Connection will be made with
t
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
Connecti arge Paid 0-Y- f Licensed Drain Layer
_.. Issue
Tax Collector
Permit Fee: Paid $
ZFL
- - - - INITIAL (Sig) _.
-FINAL (Sig)
APPROVED (Date)
(Sig)
INSPECTOR