HomeMy WebLinkAboutDrain Layers Permit 11P St Marc Circle TOWN OF SOUTH WINDSOR
DEPARTMENT OF POLLUTION CONTROL B/P No.:
South Windsor, Connecticut
List No.: _
DRAIN LAYER'S PERMIT O 3271
' 19 E
Pursuant to written ap licatior, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work i}tdicated below at - f on the
side, b tween
at premises owned by
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
•
nnection Charge Paid Q,(� Signed Licensed Drain Layer
issued y
Xo&Collector
Permit Fee: Paid $ LL d_V_
INSPECTION: Check Number: _._.
INITIAL (Sig)
- FINAL (Sig)
APPROVED (Date)
(Sig)
INSPECTOR