HomeMy WebLinkAboutDrain Layers Permit Lot A Imperial Drive Y` TOWN OF SP H ,WINDSOR " 5
DEPARTMENT OF POLLUTION CONTROL
B/P No::
South-Windsor, Connecticut
List.No.:
DRAIN LAYER',S PERMIT `,_
s
;.
Pursuatlt td written ppIicatior `perm ssIon is hereby granted to the Licensed Drain Layer named herein to perform
..,the work indicated below;;atTsit .-; la f on the
side, between— ,
at premisis owned b.
,. :. whose address is
; and to Ley House Drain, _ Repair House.Drain, Lay,Main, _Other:; ,
r.
' for occupancy,of use,:.
wit1
Family Units, with �3 acres.
Type of Sewage to be connetred'ynde{Ais permit:
SANITARY'SEWAGE j, INDUSTRIAL WAS`TES`'.
—.Connec, made.-with_.-. Ri ++ * -4
z
L
Y.
Permit to be issued
holder of Drain Layer's License No.. Permit will expire on 19
The:undetsigned Qtain Layer heeby,agrees to all the terms and conditions set forth esri the•permit and the reverse side
ti�ereof;;Applicant has received Town Rermxt No. _ and/or C II D i?erm.c No
for street eg�avaton.
SPECIAL CONDITIONS'`
;.
_ .4 . . -
Signed
Connection Charge Paid Licensed Drain Lgyer
_ - - - Issued by. -
Tax.Collector
Permit hee..;PaidMOW
;Eheck`Numer: -
INSPECTION.,•
INITIAL (Sig)
FINAL ': c, - > �4� (Sig)
APPROVED ¢ (Date)
INSPECTOR '