HomeMy WebLinkAboutDrain Layers Permit 681 John Fitch Boule (2) TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL B/P No.:
South Windsor, Connecticut
! List No.: _
DRAIN LAYER'S PERMIT NO 2601
-7/3 , 19 �z
Pursuant to written applicatior, permission is hereby.granted to the Licen ed Drain Layer named herein to perform
Ithe work indicated below at on the
s' e, between
at premises owned by C C
whose address is
and to Lay House Drain, Repair Douse 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 ao 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 CHI) Permit No.
for street excavation.
SPECIAL CONDITIONS
Signed
Connec ' Charge Paid Q-V0 Licensed Drain Layer
12%ml� ? L
A/tIssued by
Tag Collector
Permit Fee: Paid $ 7 �-f
INSPECTION: Check Number:
INITIAL (Sig)
FINAL (Sig)
-_ �A1�PROVEIS"_--__- -�-- -- � _-�_ --- � -------- _ __-----(D�r�)1----_--------- ------ �
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