HomeMy WebLinkAboutDrain Layers Permit 94 Jacques Lane TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL
B/P No.:
South Windsor, Connecticut
List No.: _
DRAIN LAYER'S PERMIT N? 3005
, 19 �
Pursuant to written ap licatior, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at 6 944 on the
side, between p
at premises owned
whose address is
and to Lay House Drain, Repair House Drain, Lay-Main, O[her
for
occupancy or use,
with Family Units, with acres:
Type of Sewage to be connected under this permit:
SANITARY SEWAGE ( j, INDUSTRIAL WASTES,.(. ), OR
Connection will be made with
ter;
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
Connection Charge Pai ,� U y 6 Licensed Drain Layer
Issued by
Permit Fee:. Paid $! �<0 0
INSPECTION: Check Number:
INITIAL (Sig)
FINAL (Sig)
APPROVED `_ -_� ----- (Date)
- -- - -- - —--- - --_ — --(Sig)- ---
INSPECTOR