HomeMy WebLinkAboutDrain Layers Permit 1421 John Fitch Boul TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL
South Windsor, Connecticut B/P No.:
List No.: _
DRAIN LAYER'S PERMIT N0 2745
Z , 19
Pursuant to written applicati`or, permis jon i hereby granted to the Lice ns d Drain Layer named herein to perform
the work indicated below at
on the
side, tween �U
at premises owned by
whose address is
and to Lay House Drain, Repair House Drain, La Mi
Yan Other
for '
occupancy or use,
with Family Units, with
acres.
Type of Sewage to be connected under this permit:
SANITARY SEWAGE ( j, INDUSTRIAL WASTES .( ), OR ( j
Connection 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
Connection Charge Paid Licensed Drain Layer
T Collector
Issued by
Lg&&h4�_ Permit Fee: Paid $
INSPECTION: Check Number: Z—'-
INITIAL (Sig)
FINAL (Sig)
APPROVED - - - -- --- - -- - - - - --�--- -
(Date)
_ -(Sig)-- - - -
'INSPECTOR -
._Ja