HomeMy WebLinkAboutDrain Layers Permit 122 Gail Lane TOWN OF SOUTH W1 N DSOR
ADEPARTMENT OF POLLUTION CONTROL
YSouth Windsor, Connecticut B/P No.:
List No.: _
DRAIN LAYER'S PERMIT N? 2769
7-7
° 19 (70&
Pursuant to written application,,permission is hereb granted to the Licensed Drain Layer named herein to perform
the work indicated below at W 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 ( ), 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 HD Permit No.
for street excavation.
SPECIAL CONDITIONS
41 �a
Signed
Connection Charge Paid yo0.6 D Licensed Drain Layer
_..__ Issued-by
ax Collector
Permit Fee: Paid $
.-INSPECTION:_
-�— INITIAL (Sig)
FINAL (Sig)
(Date)
--- - ---- - (Sig)
INSPECTOR