HomeMy WebLinkAboutDrain Layers Permit 95 High Tower Road TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL
B/P No.:
South Windsor, Connecticut 3��5
List No.: _
DRAIN LAYER'S PERMIT NO 2272
119
Pursuant t%written applicatior, permission is herebv granted to the Licensed Drain Layer named herein to performc-
the work indicated below at '_�� � �. �.�(,�a(sy- on the
Y
side, between
at premises owned d2L
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 connected under this permit:
SANITARY SEWAGE (J), 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 Charge Paid Licensed Drain Layer
Issued by
Tax Collector
A C tii�i� C� 7 Permit Fee: Paid $ -_
INSPECTION: Check Number: �llI
INITIAL (Sig)
FINAL (Sig) '
--- - - (Sig)
- - INSPECTOR - -- --- /�