HomeMy WebLinkAboutDrain Layers Permit 698 Griffin Road TOWN Of SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL
B/P No.:
South Windsor, Connecticut
List No.: _
I
DRAIN LAYER'S PERMIT ENO 2571
19
Pursuant to written applicatior, permission is herebyrante to th- Licensed Drain Layer named herein to perform
(�
work indicated below atET ` on the
side, between /
at premises owned
lrhose address is
j
land to Lay House Drain, Repair House Drain, Lay l�fan, Other
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
i
IPermit 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
/n1 Signed '
Connection Charge Paid dw U •(4) Licensed Drain Layer
Issue- wy
Tax Collector J
Permit Fee:. Paid $ _L
--- _ - ---- INSPECTION:` Check Nt�txrber: — -
- — INITIAL (Sig)
- -- FINAL (Sig)
APPROVED (Date)
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(Sig)- - -_
INSPECTOR