HomeMy WebLinkAboutDrain Layers Permit 751 Griffin Road (2) TOWN OF SOUTH WINDSOR
DEPARTMENT OF POLLUTION CONTROL
B/P No.:
South Windsor, Connecticut
List No.: _
DRAIN LAYER'S PERMIT N° 2492
, 190
Pursuant to written applicatior, p„rTiss on is hereby gr nted to the Licensed Drain Layer named herein to perform
the work indicated below at on the
side;-between
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 ( ), 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
theregf. Applicant has received Town Permit No. and/or C H D Permit No.
for street excavation.
SPECIAL CONDITIONS
Signed
Connection Charge Paid 'yQQ,d d Licensed Drain Layer
--= - Issued b _
lax Collector
Permit Fee:. Paid $
-- -----INSPEC-T-ION,-_— --..--.Check
INITIAL (Sig)
FINAL (Sig) _.
(Date)
(Sig)--
INSPECTOR