HomeMy WebLinkAboutDrain Layers Permit 151 Homestead Drive - TOWN OF SOUTH WINDSOR
DEPARTMENT OF POLLUTION CONTROL
B/P No.:
South Windsor, Connecticut
List No.: _
DRAIN LAYER'S PERMIT N? 2136
, 19bt�
Pursuant to written applicati/or, permission is hereby granted to the Lice ed Drain Layer named herei to perform
the work indicated below at 0 TM Leir )J
on the
side, between
at premises owned by D S i vt
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 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
Aa �) ..+ Signed
ne f tion Charge Paid tYDV Licensed Drain Layer
Issued by
Tax Collector n
Permit Fee:. Paid $ 45 'DO
INSPECTION: Check Number: A f
INITIAL (Sig) �I/7d j,' �<
FINAL (Sig)
-- ------- APPROVED - -(Date)
- - - -- - (Sig)
INSPECTOR
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