HomeMy WebLinkAboutDrain Layers Permit 28 Hollis Road n TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL
South Windsor, Connecticut B/P No.:
List No.: _
DRAIN LAYER'S PERMIT N? 794
, 19
Pursuant to written applicatior, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at , ( ,'`r, i >t j oT -3 c-J on the
side, between
at premises owned b y* ' } • '
whose address is
and to _Lay House Drain, Repair House Drain, Lay Main, Other
for
C_a .d_ occupancy or use,
with zr—r Family Units, with acres.
Type of Sewage to be connected under this permit:
SANITARY SEWAGE ( ,X), INDUSTRIAL WASTES ( ), OR ( )
Connection will be made with
Permit to be issued tom
the holder of Drain Layer's License No. o 4 AQ 4 t Permit will expire on 19
The undersigned Drain Layer hereby agrees to all the teAns 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
r
Signed
Connection Charge Paid Licensed Drain Layer
1.
231 Issued by
- Tax Collector
Permit Fee: Paid $
INSPECTION: Check Number:
INITIAL (Sig)
FINALi (Sig)
APPROVED " "" ,j';7 .r - ,�jt (Date)
(Sig)
INSPECTOR