HomeMy WebLinkAboutDrain Layers Permit 701 Governors Highwa (2) TOWN OF �,W TH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL B/P No.:
South Windsor, Connecticut
List No.: 'rn .
DRAIN LAYER'S. PERMIT
a 627
►"i ) 19 "
Pursuant-to written application, permission is hereby-granted to*the Licensed Drain Layer named herein to perform
the work indicated below at_ on the
side, between abum 24* r
at premises owned
whose address is
and to Lay House Drain, Repair House Drain, Lay Main, Other ,
for XV44AMU4 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 ) too PV* !
Permit to be issued to " Drrvft
the holder of Drain Layer's License No.X 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
Signed.
Connection Charge Paid ;^7 Licensed.Drain Layer
Issued by ph A.
Tax Collector
Permit Fee:. Paid $
INSPECTION: Check Number:
INITIAL (Sig)
FINAL 3 t _ ' (Sig)
:_
APPROVED- � _ �'.{,�� .<�'" (Dace)
�. (Sig)
_ INSPECTOR
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