HomeMy WebLinkAboutDrain Layers Permit 2R St Marc Circle 4
.. �. TOWN OF SOUTH WINDSOR
DEPARTMENT OF POLLUTION CONTROL B/P o.:
L .. ,._.
South Windsor, Connecticut %`
List No.: _
DRAIN LAYER'S PERMIT
O 2752
a , 19
Pursuant to written applicatior, perm' sion is hereby gr to tot a Licensed ain Layer named herein to perform,
the work indicated below at on the
side, between
at premises owned by
r
whose address is
and to Lay House Drain, Repair House Drain, Lay-Main, Otherf'
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 '
r.
p�Connection Charge Paid! 001 Signed Licensed Drain Layer
- ------ —::Issued—by.. -
---- - lector
Permit Fee Paid $ 00
- - — — -- �- — SI?E(--T-Trn) -- -=_—Check Ltu be
- INITIAL - (Sig)
FINAL (Sig)
APPROVED (Date)
--
INSPECTOR-