HomeMy WebLinkAboutDrain Layers Permit 2O St Marc Circle TOWN. .OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTRDL
B/P No.:
South Windsor, Connecticut
List No.: _
DRAIN LAYER'S PERMIT N? 3038
, 19 d�
Pursuant to written applicatior, permissi n is hhereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at lJ �--- on the
side, between
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.
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
_ Signed
Connecti arge Paid �(/ Licensed Drain Layer
- 4
-__.. __.._ _-_-- __-- Issued b ____
r Fax Collector
Permit Fee:. Paid $
INSPECTION: ---Check--Number; Z 2.
INITIAL (Sig)
FINAL (Sig)
ME (Date)
- _INSPECTOR (Sig)