HomeMy WebLinkAboutDrain Layers Permit 3B St Marc Circle TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL
B/P No.:
South Windsor, Connecticut
List No.: _
DRAIN LAYER'S PERMIT N? 2636
19
Pursuant to wgtten.ap 1'catiorr permission is hereby granted to he Licensed Drain Layer named herein to perform
the work indicated on the
side,/jIftween
at premises owned by f
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
Si ned
Connection Charge Paidn J < g Licensed Drain Layer
--- -- Issued
Permit Fee:. Paid $$
_-INSPECTION:
INITIAL
_ (Sig)
FINAL (Sig)
(Date)
- - -- - (Sig)
- INSPECTOR