HomeMy WebLinkAboutDrain Layers Permit 3S St Marc Circle TOWN OF SOUTH WI N DSOR
DEPARTMENT .OF POLLUTION CONTROL
South Windsor, Connecticut B/P No.:
List No.: _
DRAIN LAYER'S PERMIT N'O 2638
Calk tub' l:L l . J , 19 � --
Pursuant to written ap 1'catior permission is h to the Licen ed Drain Layer named herein to perform
the work indicated below at {� on the
side, betwyn—
at premises owned by J / '� k
whose address is '
V
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
DI (03
fy Signed
Connection Charge Paid Licensed Drain Layer
_ t Issued
for
Permit Fee: Paid $ I `l_ L)
NSPECTION v Check=_Nunaber fY_9Q, _ --- —
INITIAL .,. - (Sig)
FINAL (Sig)
PROVED (Date)
- - — -(Sig) -
INSPECTOR _