HomeMy WebLinkAboutDrain Layers Permit 3J St Marc Circle _
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TOWN OF SOUTH WINDSOR
DEPARTMENT OF POLLUTION CONTROL
B/P No.:
South Windsor, Connecticut
List.No.: _
DRAIN LAYER'S PERMIT O 3189
119
Pursuant to written applicatior, permission is hereby granted to th Licensed Drain Layer named herein to perform
the work indicated below at J ' - �, � J4,(y �1! (�X
on the
side, b een _
at premises owned by Q;Ja
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 jWASTES _.( ), 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
ned
onnection Charge Paid /m 0 ! Sig Licensed Drain Layer
Issue y
T/a Collectot
Permit Fee:. Paid $ _J� t�0
_.._
INSPECTION: Check-Number:
INITIAL (Sig)
- - FINAL
APPROVED (Date)
(Sig)
INSPECTOR