HomeMy WebLinkAboutDrain Layers Permit 147 Garnet Lane (2) TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL B/P No.:
South Windsor, Connecticut
List No.: _
DRAIN LAYER'S PERMIT O 3308
olmt-oz, ) 19�.
Pursuant to written app(li�tior, permissio i hereby granteA to the Licensed Drain Layer named herein to perform
the work indicated below at rya/ �'"' , . �� p �.t�� 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
Signed
Connection Charge Paid Licensed Drain Layer
- issued y
- - - — -- —
a/( . Tax Collector _
Permit Nee: Paid $
NSPECTION: Check Number. -•-- _
INITIAL (Sig)
-- FINAL -. (Sig), APPROVED (Date)
INSPECTOR (Sig)
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