HomeMy WebLinkAboutDrain Layers Permit 77 Gail Lane TOWN OF SOUTH WI N DSOR
�J DEPARTMENT OF POLLUTION CONTROL
South Windsor, Connecticut B/P No.:
List No.: _
DRAIN LAYER'S PERMIT N0 2647
712,
Pursuant to written applic�t .or, permission i hereby granted to t e Licensed Drain Layer named herein to perform
the work indicated below at F/-ram 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 U Permit No.
for street excavation.
SPECIAL CONDITIONS
,r Signed
tio Connec rge Plaid vv Z �L Licensed Drain Layer
- -- - -
of I
__ ---._...Issued..by:
Collector
i
Permit Fee: Paidj� Lam, t
-- --__INSPECTION:--------__t-Check_1�uLex,_ —
FINAL (Sig)
"{Date)
-- (Sig)
INSPECTOR