HomeMy WebLinkAboutDrain Layers Permit 15O St Marc Circle fir.. ..rfur-. ,.{. n ,..,.--,�P�'itr,�..w---r��ssr.rmsp*J+y�q+•r+- 3�. + .
TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL gip No.:
South Windsor, Connecticut
List No.: _
DRAIN LAYER'S PERMIT lr0 3 19
iL 2X3 ' A? s
Pursuant to written applicatior, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at �/�CY 0 on the
side, betw n
at premises owned by /9411<
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 tai be c nected under this permit:
SANITARY SEGEdd( ), NDLTSTRIAL WASTES .( ), OR
Connectionwill l mad` `with
q
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.
j
SPECIAL CONDITIONS
ri
Signea
Conne n Charge Paid Licensed Drain Layer
' Tax Collector
Permit Fee: Paid $ 2
INSPECTION: --- Check Number
t
INITIAL (Sig)
--- FINAL (Sig)
APPROVED (Date)
- - (Sig) _ - -- - -
INSPECTOR
1