HomeMy WebLinkAboutDrain Layers Permit 10P St Marc Circle�+.--s-.pr.....,. ....yg4r�„`y.:.-"�n-.37.FR1.•�'�{�}Ii�C1<<�r�.21!t"!f'.yyi•• 'iJ4• �:. • - '
TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL B/P No.: _
South Windsor, Connecticut
List No.:
DRAIN LAYER'S PERMIT 3270
l 7 , 19
Pursuant to written applicatior, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at /
on the
side, between
at premises owned by
whose address is
and to Lay House Drain, Repair House Drain, Lay Main, Other
for occupancy or use,
with Family [Inits, 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
g •� Signed
onnection Charge Paid D v, Q IS Licensed Drain Layer
- -- -- -- --- _.P t
ssue y
aTO&t /„ ,��t•� Permit Fee: Paid $
INSPECTION: Check Number:
INITIAL (Sig)
- FINAL
APPROVED (Date)
(Sig) -
INSPECTOR