HomeMy WebLinkAboutDrain Layers Permit 3O St Marc Circle TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL
B/P No.:
South Windsor, Connecticut
List No.: _
DRAIN LAYER'S PERMIT N? 3039
/G 191
Pursuant to written applica ior, permiss'on is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at on the
f
side, betwe
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 ( j, 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
n' /G / Signed
Co arge Paid p Licensed Drain Layer
-
-_-------�nnectio
issued by _. _ _---- ---- _ _ ___. . _ - _ --_ _- ____
Tax Collector
Permit Fee: Paid
.INSPECTION: Check-Number: Z _
--- INITIAL (Sig)
- FINAL (Sig)
APPROVED (Date)
-- (Sig) - - _
INSPECTOR