HomeMy WebLinkAboutDrain Layers Permit 54 Garnet Lane (2) TOWN OF SOUTH WINDSOR
DEPARTMENT OF POLLUTION CONTROL
B/P No.:
South Windsor, Connecticut
List No.: _
DRAIN LAYER'S PERMIT No 3363
ZC , 19
Eursuant to written applicati r permission is hereby granted to the Licensed Drain Lay r named herein to perform
R ,. - .� 3
» the work indicated below at__� on the
side, betwe
at premises owned by
r 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 D Permit No.
for street excavation.
SPECIAL CONDITIONS
't
Signed
Co tion Charge PaidIJA Licensed Drain Layer
2:
issued by
—
Tax Collector
Permit Fee: Paid $
INITIAL
(Sig)
FINAL (Sig)
APPROVED (Date)
(Sig)
- INSPECTOR