HomeMy WebLinkAboutDrain Layers Permit 31 Hillside Drive TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL gip No.:
South Windsor, Connecticut
List No.: _
DRAIN LAYER"S PERMIT �O 3579
3 , 19 (l J
Pursuant to written appllicatior, permission is ereby granted to the Licensed Drain Layer named herein to perform
th work indicated below at J / �X�.(�1l on the
side, between
at premises owned b
hose 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
2 y5 two d.o o ,
Signed mil'+► �'Y
nnection Charge Paid an (�'� Licensed brain Layer
� Issued by
T x ollect
Permit Fee: Paid $ _�J( oU
INSPECTION: Check Number: -
INITIAL (Sig)
FINAL (Sig)
APPROVED` (Date)
_(Sig)
INSPECTOR