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HomeMy WebLinkAboutDrain Layers Permit 735 John Fitch Boule TOWN OF SOUTH WI N DSOR DEPARTMENT OF POLLUTION CONTROL South Windsor, Connecticut DRAIN LAYER'S PERMIT N© 12 -tjAkdo 719 4.9— Pursuant to written application,, permission is hereby granted to the Licensed Drain Layer named herein to perform the work indicated below at A., ...t on the side, between at premises owned by #.� it whose address is AA"---`� " 9t#,P is and to Lay House Drain, Repair House Drain, Lay-Main, Other ` for ar►Aga$d'A occupancy or use, with + Family Units, with acres. Type of Sewage to be connected under this permit: ITARY INDUSTRIAL WASTES, OR Connection will be-made with A -Odep Permit to be issued to .at. -M " the holder of Drain Layer's License No. A*16 * Permit will expire on 11 " f 19 The undersigned Drain Layer hereby agrees io all the terms and conditions set forth on the permit and.ffhe reverse side thereof. Applicant has received Town Permit No. and/or C H D Permit No, for street excavation. SPECIAL CONDITIONS Signed ;Connection Charge Paid $ ticensed_brain Layer (Sig) Issued by *jj J�&. Tax Collector Permit Fee: Paid $ INSPECTION: 'wo. s . INITIAL (Sig) FINAL (Sig) APPROVED (Date) -- --- I&A - - - (Sig) - OR