HomeMy WebLinkAboutDrain Layers Permit 62 High Ridge Road ;.TOWN ' 'OF SOUTH WINDc. y
DEPART S
MENT OF' POLLUTION CANTS#Q.
South Windsor, Connecticut
DRAIN` L'A'YER'S PERMIT ; S- X
N° 293
t . r „ 1
Pursuant to written application, permission is hereby granted to the Licensed Drain Layer named herein to
the work indicated below at :, . ' _ perform
on the
side, between
at premises owned by '
whose >
and to Lay.House Drain, -Repair House Drain,
Other
Lay Main,.
for
with ; r ' occupancy or use,
Family Units, with
acres.
Type of Sewage to-be connected.under this permit:
SANITARY SEWAGE, INDUSTRIAL WASTES, OR
Connection will be made with k.: ------------
-- --_ -- - - - --- -
Permit to'be issued to ; .
4,,Al
the holder,of Drain Layer's License No._+�r�
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.
for street excavation. and/or C H D Permit No.
SPECIAL CONDITIONS
J
mil. �x
Connection Charge Paid �' 1 Signed f E a , r ��P
Licensed Drain Layer
Tax Collector (Sig) Issued by
Permit Fee: Paid Sd'y' viF
INSPECTION: .
INITIAL
(Sig)
Sig)
- (Sig)
APPROVEDk.
(Date)
* INSPECTOIt (Sig) .