HomeMy WebLinkAboutDrain Layers Permit 8P St Marc Circle (2) TOWN OF SOUTH WIN DSO R
DEPARTMENT OF POLLUTION CONTROL B/P No.:
South Windsor, Connecticut
List No.: _
DRAIN LAYER'S PERMIT
O 3296
' 19
Pursuant to written applicattior, permission is hereby granted
ranted to the Licensed Drain Layer named herein to perform
the work indicated below at P o / /� J�-� on the
side, betwee
at premises owned by
whose address is
and to Lay House Drain, Repair House Drain, Lay Main, Other
for occupancy or use,
with Family LTnits, 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 4100.U U Licensed Drain Layer
ssued- y
_ Tag Collector
Permit Fee: Paid $
INSPECTION: Check 1Vumber,
INITIAL (Sig)
FINAL (Sig) -
APPROVED (Date)
(Sig)
INSPECTOR