HomeMy WebLinkAboutDrain Layers Permit 7E St Marc Circle _. - _ '^ "¢cam .. �i•.
TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL
B/P No.:
South Windsor, Connecticut
List No.: _
DRAIN LAYER'S PERMIT N? 2749
Pursuant to written applicatior, permission is hereby gra red to the Licensed D an Layer named herein to perform
the work indicated below at — on the
side, between 1
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 1jo. 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
,Connection Charge Paid 46.�rj /�/��3 Licensed Drain Layer
---— Issued-by -
ax CQpector
Permit Fee:. Paid $
— --INSPECTION:-
pr
- -- - ------- INITIAL - -
(Sig)
_ FINAL (Sig)
(Date)
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INSPECTOR