HomeMy WebLinkAboutDrain Layers Permit 7R St Marc Circle TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLMON CONTROL
B/P No.: _
South Windsor, Connecticut
List No.:
DRAIN LAYER' S PERMIT ? 2797
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Pursuant to written appffli atior, ermission its hM-7-:w7AII
ntethe LFo-yk
nsed MD
n Layer named herein to perform
the work indicated below at 1. I . S on the
b
side, be ween(
// i t_
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 ( 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 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
41.
Signed
Connection Charge Paid U-( , Cro Licensed Drain Layer
• _A Issued by -
Talt Collecto
�✓t �ti = � Permit Fee:. Paid $
1
.Q INSPECTION: Check Number:
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
---- -_ (Sig)
INSPECTOR