HomeMy WebLinkAboutDrain Layers Permit 85 High Ridge Road TOWN OF SOUTH WINDSOR
DEPARTMENT OF POLLUTION CONTROL
South Windsor,Connecticut B/P No.:
List.No.:
DRAIN LAYER'S PERMIT N? -
1381
19
Pursuaot to written aplicatior, per lion`ls htpra ted to the a ed Drain Layer named herein to"perform
the work dicated low at �
lam/
on the
side; Cl cif
at premises owned by
whose address is
and to Lay Housebrain, Repair House Drain, , v
Lay i�3 n, Orl'er
for
with Family
Units;with
occupancy or use,
_
acres.
Type of Sewage to be connected`under th' permit:
SANITARY SEWAGE INDUSTRIAL WASTS -
Connection will be made with , 141.z,
Petmit robe issued to
the holder of Dr4n,Layet's License,No.
Permit will egpjre on ' 19-
The undersigned'Drain.Layer fiereby agrees to'all the terms and conditions set forth•on the permit and t e'ie_verse side
thereof. Applicant has received Town_Permit No. �c
for street excavation. alid/or C?"H D�Perini-No. '
SPECIAL CONDITIONS
l .; � Signed,
Connection Charge Paid 1 Signed
7
LicentfedDrain-Layer
Tag-Collector Issued by
Permit"Fee:. Paid
INSPECTION- Check Number:
INITIAL (Sig)
FINAL (Sig)
APPROVED
t
INeuPECTOR --- - (Sig)
r
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