HomeMy WebLinkAboutDrain Layers Permit 16P St Marc Circle TOWN OF SOUTH WINDSOR
DEPARTMENT OF POLLUTION CONTROL Bhp No.:
South Windsor, Connecticut
List No.: _
DRAIN LAYER'S PERMIT O 3317
195�_
Pursuant to written appvcatior, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at 4I ( P/f0 on the
Side, b tween
at premises owned byMAtfxx Jlku LLJC ,
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
onnection Charge Paid t7 Q Licensed Drain Layer
Issued by
con
ec rij l '
Permit Fee: Paid $ LPL=_Q0_
INSPECTION: Check Number:
INITIAL - (Sig)
APPROVED (Date)
4
(Sig) -- _
INSPECTOR