HomeMy WebLinkAboutDrain Layers Permit 136 Jacques Lane ' s
TOWN OF SOUTH WINDSOR
DEPARTMENT OF POLLUTION CONTROL
B/P No.:
South Windsor, Connecticut
List.No.: _
DRAIN LAYER'S PERMIT NO 3182
G� , 19
GO
Pursuant to written applic tior, miss onn is hereb ranted to the Licensed Drain Layer named herein to perform
the work indicated below at V 1 a T C C lJ
on the
side, between
at premises owned
whose address is
and to Lay House Drain, Repair House Drain, Lay-Main, Other
for
occupancy or use,
E .
with Family Units, with acres.
Type of Sewage to be:connected under this permit:
SANITARY SEWAGE ( ), INDUSTRIAL WASTES .( ), OR
_ Co_nnecti-on 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
Signed
C nnection Charge Paid 2 Licensed Drain Layer
�
� Issued by
x Collector t h_
Permit Fee: Paid $
INSPECTION: Check Number: l
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
-- --- _ Sig- - -
INSPECTOR