HomeMy WebLinkAboutDrain Layers Permit 58 Highland Drive TOWN OF SOUTH WINDSOR
DEPARTMENT OF POLLUTION CONTROL
B/P No.:
South Windsor, Connecticut �p J 3 ZS
List.No.:
DRAIN LAYER'S PERMIT Np 1380
19
Pursuant to written application rmis. ' is h re y granted to the Licensed Drain Layer named herein to perform
the w indicat d below at. lf'G on the
side, betwe T/,-a
r
at remises owned b 1� >7
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 ( y, INDUSTRIAL ASTES
Z�
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
/ Signed Te
Connection Charge Paid 11 Licensed Drain�Laver
72 Issued by
Tax Collector f`
Permit Fee:. Paid $
INSPECTION: Check Number:
INITIAL (Sig)
FINAL (Sig)
APPROVED "YY" (Date)
i9&ezT�f'l— . (Sig)
INSPECTQ
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