HomeMy WebLinkAboutDrain Layers Permit 8P St Marc Circle TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL Bhp No.:
South Windsor, Connecticut
List No.: _
DRAIN LAYER'S PERMIT 10 3314
4 , 19 a 'T
Pursuant to written applicatior, permission is hereby,granted to the Licensed Drain Layer named herein to perform
the work indicated below at 1� 0, O on the
side, be ween
at premises owned byI P c....
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
Connection Charge Paid Licensed Drain Layer
issued y
.T x Collecygr
Permit Fee: Paid
INSPECTION: Check`Number:
INITIAL (Sig)
-- FINAL - (Sig) _ -
APPROVED (Date)
(Sig)
INSPECTOR