HomeMy WebLinkAboutDrain Layers Permit 4S St Marc Circle 4. ..,. _.........._.-,.ors._.,-..-..T.. .......-'^0 :7c'* .r.
TOWN OF SOUTH WINDSOR
DEPARTMENT OF POLLUTION CONTROL
South Windsor, Connecticut B/P No.:
List No.: _ T_
DRAIN LAYER'S PERMIT N0 2664
, 19 � Z
Pursuant to written applicatior., permissio is hereby grant to the 'tensed Drain Layer named herein to perform
the.work indicated below at on the
side;b tw en )
at premises owned b I
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
Signed
C nection Charge Paid a Ci' L Licensed Drain Layer
Ala_ — Issued:by _
--
C` Permit lee: Paid $�� .�1'U
Check_Number:- j4
---- --� INITIAL
- —- - (Sig)
FINAL (Sig)
APPROVED (Date)
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- — - --- INSPECTOR