HomeMy WebLinkAboutDrain Layers Permit 1K St Marc Circle TOWN OF SOUTH WINDSOR
DEPARTMENT OF POLLUTION CONTROL
B/P No.:.
South Windsor, Connecticut
List.No.:
DRAIN LAYER'S PERMITOis8
Pursuant to written applicatiorr,, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below,at /1.(�f #C -' f on the
side, b tween
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.
R
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 ion 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 400. 6 o � Licensed Drain Layer
issued y
,Tab Collecpqr
Permit Fee:. Paid $ _
INSPECTION: �hec -Number:
INITIAL (Sig)
-- -- - FINAL --
APPROVED (Date)
(Sig)
INSPECTOR