HomeMy WebLinkAboutDrain Layers Permit 7Q St Marc Circle TOWN OF SOUTH WINDSOR
DEPARTMENT OF POLLUTION CONTROL
South Windsor,'Connecticut B/P No.:
List No.: _
DRAIN LAYER'S PERMIT Np 42 -
Pursuant to written applicat' , permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at_,
on the
side, bete e
at premises owned by--L.
V
whose address is
and to Lay House Drain, Repair House Drain, La -Main,'''-Yan� Other
for '
occupancy or use,
with Family Units, with
acres.
Type of Sewage to be connected under this permit:
SANITARY SEWAGE ( j, 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 1
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 Licensed Drain Layer
Issued b
�T�Col-lector. -- Y
Permit Fee:. Paid $ __'`_._ �f
INSPECTION: Check Number. 1�
INITIAL (Sig)
FINAL
(Sig)
_APPROVED - -- — -
INSPECTOR (Sig) -
r'