HomeMy WebLinkAboutDrain Layers Permit 4N St Marc Circle TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL BAP No.:
South Windsor, Connecticut
List.No.: _
DRAIN LAYER'S PERMIT O 3321
, 19 5�1)
Pursuant to written a p 'catior, tpermission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at N' on the
side, b AtT een
at premises owned by
aA4 F11=1 Aka L-
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 and the reverse side
thereof. Applicant has received Town Permit No. and/or C H D Permit No.
for street excavation.
SPECIAL CONDITIONS
K r
1 Signed
Connection Charge Paid - Licensed Drain Layer
-- -- _
Issued by
x Gollec r4��, �W L --
Permit Fee: Paid $ _
INSPECTION: Check Number:
INITIAL (Sig)
FINAL_ - - - (Sig)
APPROVED (Date)
(Sig)
INSPECTOR