HomeMy WebLinkAboutDrain Layers Permit 4Q St Marc Circle (2) TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL
B/P No.:
South Windsor, Connecticut
List No.• _
DRAIN LAYER'S PERMIT NO 2929
19 3
Pursuant to written applicat: or, permissio y -n is hereby granted to the Licensed Drain Layer named herein to perform
,
the work indicated below at ' � ^- on the
si e, 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 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 3 Licensed Drain Layer
Issued by
Permit Fee: Paid $
INSPECTION: Check Number:
-- - - INITIAL (Sig) •
FINAL (Sig)
- - ARPRaV-£D - --
-- - - - (Sig) -
INSPECTOR -`