HomeMy WebLinkAboutDrain Layers Permit 22 Hollis Road (2) : .. TOWN OF SOUTH 'WINDSQ'
DEPARTMENT OF POLLUTION CONTROL
B/P No.: .
South Windsor, Connecticut
List.No.:
DRAIN LAYER'S PERMIT p 76
19
Pursuant ro written applicatior, permission'is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at it lrwii,;. op the
Sid
e, between
at premises ownedb
whose addres s'is
and to 9 Lay House Drain, Repair House Drain, `__Lay Main, Other
for, - occupancy or use,
with Family Units`, with goes.
Type of Sewage to be connected under this permit:
SANITARY SEWAGE INDUSTRIAL. WASTES OR
onnnst on_wilLbe-made-wiil�� i = E - -- -- - -- - - -- --
k _
Permit to be issued to
r' the holder of Drain Layer's License No._ Permit:will esp�re on - 19 _
The undersigned Drain Layer hereby agrees"to'all the terms and conditions set forth on the permit dnd the reverse side"
thereof. Applicant has received Town Permit No. and/or C H D Permit No �•
for street excavation. :.
SPECIAL CONDITIONS
T
Signe f
Connection Charge Paid _- Licensed Drams Layer,:
Issued b ' '
Tag Collector
Permit Fee:. Paid $
INSPECTION: Check Number: t
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date) .
—_; (Sig)
INSPECTOR