HomeMy WebLinkAboutDrain Layers Permit 115 Gail Lane (2) TOWN OF SOUTH WINDSOR
DEPARTMENT OF POLLUTION CONTROL
B/P No.:
South Windsor, Connecticut
List No.: _
DRAIN LAYER'S PERMIT
0 2495
Pursuant to written applieatior, permis iqn is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated belodi at i� J— 1 { kLIU'IAA -- + 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 ( ), 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 `
d 11 \ Signed
Connection Charq_Paid . ( ��.p,�}' Licensed Drain Layer
Issued b
l i _ Tax Collector
Permit Fee: Paid $
INSP-EC-T--ION-;- - --—Check--Number:
INITIAL _ (Sig)
FINAL (Sig)
PPROVED (Date)
--- - (Sig)
- -. .. INSPECTOR
1