HomeMy WebLinkAboutDrain Layers Permit 38 Hayes Road TV
TOWN Of- SOUTH IN,DSOR
DEPARTMgNT OF POLLUTION .CONTROL gip No.:
South Windsor, Connecticut
List No.: _
DRAIN LAYER'S PERMIT O 3351
ye
19
Pursuant to written applicatior, perm'ss'on is hereby a d to the Licensed Drain Layer named Herein to"p`ffo-
the work indicated below at on the
side, betty n
at premises owned b
� .
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
T `undersigned Drain Layer hereby agrees to all the terms`and conditions set forth on the permit d the reverse side'
thereof. Applicant has received Town Permie No. and/or C H D Permit No.
for street excavation.
SPECIAL CONDITIONS
t'
' Signed y
nnection a Paid , Licensed Drain Layer
Issued by
tax Collector
f�
Permit Fee:. Paid $ 1"
INSPECTION: Check Number: ---�—
IAL (Sig)
FINAL (Sig)
APPROVED (Date)
_._
d
INSPECTOR (Sig)