HomeMy WebLinkAboutDrain Layers Permit 3H St Marc Circle TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL BAP No.:
South Windsor, Connecticut
List No.: _
DRAIN LAYER'S PERMIT N? 2818
Pursuant to written applicatior, permission is ereby granted to•the
/Lic used Drain Layer named herein to perform
the work indicated below at . R�c�Y S on the
side, between _
at premises owned -
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 ( j, 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 terims 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
;L Signed
Connection Charge Paid4f aq, no 11'9 o,3 Licensed Drain Layer
. Tag,Collet
Permit Fee: Paid $ _/��y /�d_p
INSPECTION: - --. Check Number: - 4 �1 --
INITIAL (Sig)
- FINAL (Sig)
APPROVED (Date)
- - - - - (Sig)
INSPECTOR