HomeMy WebLinkAboutDrain Layers Permit 556 Graham Road TOWN OF SOUTH WINDSO
DEPARTMENT OF POLLUTION--CONTROL'
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South Windsor, Connecticut
List No.: _
DRAIN LAYER'S PERMIT N? 2552
19 ��
Pursuant to written appli�cati/o_r, pe mission is her grant to the Licensed Drain Layer named herein to`perform
the work indicated below at ��� i/�1lilllJJ on the
side, betty en
at premises owned by-
whose address is
and to Lay House Drain, Repair House Drain, Lay Main, Other
l
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
lI Signed
Connection Charge Paid` ry�_ Licensed Drain Layer
Issued--b_
( - Tax Collector
Permit Fee: Paid $ _//5 d7)
INSP'ECTIONs Cheeky NtYrriber:
INITIAL (Sig) -
FINAL (Sig)
APPROVED (Date)
- (Sig) -
INSPECTOR