HomeMy WebLinkAboutDrain Layers Permit 50 Highland Drive -�- TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL B/P No.:
South Windsor, Connecticut 6�2 3
List.No.: _
DRAIN LAYER'S PERMIT Np 1348
19
Pursuant to written applicatiioor, permiss.on is hereby granted tP� Licensed Drain Layer named herein to perform
the work dicated, low at J 0 e I/ 1 Jb", on the
side, between
at premises owned by 4011el
whose ddress is
and to YLay 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
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
i
Signed
Connection Charge Paid 111S-5 Licll9ed Drain Lay r•
Issued by
Tax Collector _
Permit Fee:. Paid $ _ A ' �}
INSPECTION: Check Number: ���
INITIAL (Sig)
FINAL (Sig)
APPROVED 7 (Date)
He,f (Sig)
INSPECTOR
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