HomeMy WebLinkAboutDrain Layers Permit 1P St Marc Circle TOWN Of SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL B/P No.:
South Windsor, Connecticut
List No.: _
DRAIN LAYER'S PERMITO 3227
, 19 L�
Pursuant to written ap licatior, permission is hereby granted to the Licensed Drain Layer named herein to-perform
the work indicated below at _ V 1 on the
side, b tween
at premises owned b
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
r
4
i
Signed '
Connection Charge Paid 6 8 -�q y Licensed Drain Layer
issuedy
x Collector )
Permit Fee: Paid $ 1 0._b
-_ - - - .---Check_Nuriiber:_`_�-17 3
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
(Sig)
INSPECTOR