HomeMy WebLinkAboutDrain Layers Permit Lot B Imperial Drive TOWN OF SOUTI H . WINDSOI
DEPARTMENT 0 POLLUTION CONTROL: B/P No.: •,,l "«`
South Windsor, Connecticut
List No.:
DRAIN LAYER',S PERMIT ;. � O
,- 591
6
' 19
Pursuant'to;written applicatior,,permission is;hereby granted to the Licensed Drain Layer named herein to perform
t the work in below#Lt on the
side, between 114
at;premises owned by-
whose
address is
:and to. . I,ay House Drain, Repair House Drain, I,ay Main,. ocher .
for x`
occupancy or use,
� •
j with Family Units, wit acres. .
Tyk,Q Sewage to be connected under this permit:
SANITARY SEWAGE ( j,-INDUSTRIAL WASTES .( ), OR ( )
! Y
Connect�c n11:_he_made:wtli _ --
R
,S pernq t,to,be:.is's
a
t�' holder of brain Layer's License o�.` Permit will spite on l9
undersigned Drain Layer hereby agrees to all the terms and conditions serforth on the permit and the reverse side
;�thereaf, Applicant has received Town Permit No. and/or C H D Permit No.
or,street.est:kvation
SPECIAL CONDITIONS '
- ySigtl4d :
Connection Charge Paid Licensed Drain L er
�_ 36 s ;
- = Issued by,. .A S a
Tax Collector
Permit Fee:. Paid $
- INSPECTION Check Number:
INITIAL " (Sig)
FINAL — � s (Sig)
APPROVED a•�: " (Date)
-INSPICTOR