HomeMy WebLinkAboutDrain Layers Permit 148 Homestead Drive TOWN OF SOUTH WINDSOR
• DEPARTMENT OF POLLUTION CONTROL
South Windsor, Connecticut B/P No.:
List No.: _ D
DRAIN LAYER'S PERMIT N? 2208
I9?D
Pursuant to written applicatior, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at J10i 11 D T1,V71,7,er x) 4 e on the
side, between " >
at premises owned by DUS! 1 tic .
whose address is It
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
rJ r;
oP�d Q Signed
Connection Charge Paid L100 " Licensed Drain Layer
Issued by
Tax Collector j r
pU
Permit Fee:. Paid $ 6
INSPECTION: Check Number: _
INITIAL (Sig)
FINAL (Sig)
APPROVED - - - -- --— -- - -_(Date)
- - -- - - (Sig)
INSPECTOR