HomeMy WebLinkAboutDrain Layers Permit 153 Gail Lane TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL
South Windsor, Connecticut B/P No.:
List No.: _
DRAIN LAYER'S PERMIT NO 2646
>53 J`la :ej , 19 z--
Pursuant to written applicatior, permission is he eb granted to the Licensed Drain Layer named herein to perform
the work indicated below atW.
on the
side, be�tween
at premises owned by
whose address is
and to Lay House Draia, 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
Conne2- -AA
rge Paid 1.(� f L L— Licensed Drain Layer
— - - Issued.by.
x Collector
Permit Fee: Paid $
- INSPECTION_.-_.- _- '_Check-,Number:-.-
--------(Sig)
FINAL (Sig)
ate
(Sig)
---- — ----- INSPECTOR