HomeMy WebLinkAboutDrain Layers Permit 20 High Tower Road TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL
South Windsor, Connecticut B/P No.:
List No.: _
DRAIN LAYER'S PERMIT N? 2406
, 19
Pursuant to written applicatior, Vermisspon is hereby granted t he Licensed Drain Layer named herein to perform
a
the work indicated below at on the
side, betwe
at premises owned by
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 ( ), 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
� Signed
Connection Cbarge Paid Licensed Drain Layer
Issued by
Tax Collector
dZ
Permit Fee: Paid $ �
INSPECTION: Check Number: 9 3�
INITIAL (Sig)
FINAL (Sig)
--APPROVED- -- --- - (Date)
- ---
INSPECTOR :(Sig)..
-- --- -----