HomeMy WebLinkAboutDrain Layers Permit 39 High Street TOWN OF SOUTH WINDSOR
DEPARTMENT OF POLLUTION CONTROL
B/P No:
South Windsor, Connecticut
List No.::
DRAIN LAYER'S PERMITO 3247 I•
19 0,0Y h
Pursuant to written applicatior, permissi n is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at C/ on the
si e, between
at premises owned b 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 madewith - -- — -
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
Connection Charge Paid UQ•Q 0 Licensed Drain Layer
Issued by
ax Collector
Permit Fee:. Paid $
INSPECTION: Check Number: �� _
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
- - (Sig) —
INSPECTOR