HomeMy WebLinkAboutDrain Layers Permit 138 Gail Lane V , TOWN OF SOUTH WI N DSOR
� ' DEPARTMENT OF POLLUTION CONTROL
South Windsor, Connecticut B/P No,:
List No.: _
DRAIN LAYER'S PERMIT NO 2582
19 /)
lag
Pursuant to written app scar r, permission is hereby granted to the Licensed Drain Layer,named herein to perform
the work indicated below at
on the
side, betty en
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 H D Permit No.
for street excavation.
SPECIAL CONDITIONS
?
p Signed
C nnection Charge Paid4 DT. 7 0 Licensed Drain Layer
c „
--
�� _ Issued b -". -
a o cto
Permit Fee:. Paid
---INSPECTION:----- CCh!N-k—Numhe
`_"INIT (Sig)
FINAL (Sig)
(Date)
(Sig)
INSPECTOR