HomeMy WebLinkAboutDrain Layers Permit 5M St Marc Circle TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL Bhp No.:
South Windsor, Connecticut
List No.: _
DRAIN LAYER'S PERMIT NO 3160
Pursuant to written applicatior, permission is hereby granted
ranted to the Licensed Drain Layer named herein to perform
the work indicated below at -_ Lf �27 fY�K',t�- �'�� on the
side, between
at premises owned by J
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 No, Permit will expire on 19
The undersigned Drain Layer hereby, agrees to all the.terms and conditions set forth on the permit anq the reverse side
thereof. Applicant has.received Town Permit No. and/or C H D Permit No.
for street excavatoi. _
SPECIAL CONDITIONS
C7:9y9 CV-a3 -d
Signed
Connection Charge Paid yOD.d,� Licensed Drain Layer
-
issued y
Tax Collector
' Permit Fee:. Paid $ _,lff-._
INSPECTION: Check Numbers`- `J�
INITIAL (Sig)
- FINAL - (Sig) -
4 APPROVED (Date)
is -- (Sig)
INSPECTOR