HomeMy WebLinkAboutDrain Layers Permit 4I 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? 2983
19 Kt _
Pursuant to written applicatior, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at on the
side, between
at premises owned by jet
01
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
( i, INDUSTRIAL WASTES ,OR ( )
Connection will be made with
Permit to be issued to
the holder of Drain Layer's License No.'
„_� Permit will expiie on 19
The undersigned Drain Layer herby 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 = >
=CFI
Signect
Connection Charge Paid Licensed Drain'Lager -
Issued.b
Tax o ector
Permit Fee: Paid $ lw
C. Number:_
-- -- - INITIAL (Sig)
- - FINAL (Sig) I
(Date) - -
(Sig)-
- INSPECTOR