HomeMy WebLinkAboutDrain Layers Permit 24 Highland Drive "OUTH - WIN DSO R f/
DEPART` ENT OF POLLUTION,,M CONTROL .
a FSouth Windsor, Connecticut
. ,DRAIN LAYER'S PERMIT. `O
253
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Pursuant to written application, permission is hereby granted to the Licensed Drain Layer,named herein to perform
the work indicated below at
'' '�� � �'`''� on the
jr_, ` side, between
- at premises owned by :, . . ? : . ,d
whose address is `°`� •
and to : v Lay House Drain, Repair House Drain, Lay Main, Other
for
i occupancy or use,
with `Family Units, with acres.
Type of Sewage to be connected under this permit:
(SANITARY SEWAGE,y 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 9'7f
The undersigned Drain Layer hereby agrees to all the terms and conditions set forth on the permit and the xcWerse side
thereof. Applicant has received Town Permit No. and/or C H D Permit No.
for street excavation;
SPECIAL CONDITIONS t
Signed
Connection Charge Paid - License' d�'rafb Laye --
_ Si Issued by .. .; .
€ 'Tax Ct511cr' tor. �. ; ,
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A
Permit Fee: Paid $
INSPECTION:
INITIAL (Sig)
FINAL (Sig)
. APPROVED (Date)
(Sigh
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IN CT R