HomeMy WebLinkAboutDrain Layers Permit 5P St Marc Circle TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL Bhp No.:
South Windsor, Connecticut
List.No.: _
DRAIN LAYER'S PERMIT N? 3231
, 19
Pursuant to written a p icatior, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at ^-- P- on the
side, tween
at premises owned b i✓
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 HID Permit No.
for street excavation.
SPECIAL CONDITIONS
�j Signed
C nection Charge'Paid 0,u t Licensed Drain Layer
- =- -
issued y
T Gollec
_ � vv
Permit Fee: Paid $
Check Number.—
INITIAL (Sig)
- - FINAL
(Sig). .
APPROVED (Date)
(Sig)
INSPECTOR