HomeMy WebLinkAboutDrain Layers Permit 401 Governors Highwa (3) TOWN OF SOUTH WINDSOR
DEPARTMENT OF POLLUTION CONTROL
:
South Windsor, Connecticut B/P No.
List No.: _
DRAIN LAYER'S PERMIT N'O 2602
h/�Z , 19 � e—
Pursuant to written applicatior, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at y�l on the
si e, 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 D Permit No.
for street excavation.
SPECIAL CONDITIONS
Signed
Con on Charge Paid 1,024,.— W73 7 f Licensed Drain Layer
-
ax _--
Permit Fee: Paid _L��_ 7 /l+L ��s�z
Numb�x--_�/L/ -
'IL --- -—- (Sig)
FINAL (Sig)
APPROVED (Date) -
(Sig) - 4
- INSPECTOR