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HomeMy WebLinkAboutDrain Layers Permit 85 High Street ,z TOWN OF SOUTH WI N DSOR `. r` DEPARTMENT OF POLLUTION CONTROL B/P No.: ; South Windsor,.Connecticut List No.: _SG©7 Jf9 DRAIN LAYER'S PERMIT a 940 a Pursuant to written applicatior, permission is hereby granted to the Licensed Drain Layer named herein,to perform the work indicated below at6s (Ut" } ftl"fNt on the Xth side,.between .—,at premises owned'by Mt whose address is and to "X Lay House Drain, Repair House Drain, Lay Main, Other for lmmdA�tj rt occupancy or use, with Family Units, with acres. Type of Sewage to be connected under this permit: SANITARY SEWAGE (t ), INDUSTRIAL WASTES OR ( ) Connection will be made with aft I m ak *24su a d- po Permit to be issued to Xe► lA' �. ts�btieei the.holder of Drain Layer's License No. Permit will expire on q 9 flafobftw 1 The undersigned Drain Layer hereby agrees to all the terms and conditions set forth on the permit an the reverse si e thereof. Applicant has received Town_Permit No. and/or C H D Permit No. for street excavation. SPECIAL CONDITIONS Signedf� 7� Connection Charge Paid E�q _ Licensed.Drain Layer Issued by N. 2UMMI rriftd Tax Collector Permit Fee: Paid $ INSPECTION: Check Number: ---� _ INITIAL (Sig) FINAL (Sig) ----- - APPROVED (Date) - - (Sig) INSPECTOR -