HomeMy WebLinkAboutDrain Layers Permit John Fitch Boulevard (2) TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION -CONTROL
South Windsor, Connecticut
DRAIN LAYER'S PERMIT NO 8
10 *so , Igo
Pursuant to written application, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at on the
+ ' side,
at premises owned by iI 0:. .
whose address is
and to — _Lay House Drain, - Repair:House Drain, Lay Main, Other
for occupancy or use,
with Family Units, with acres.
Type of Sewage to be connected under this permit:
SANITARY SEWAG INDUSTRIAL WASTES, OR
Connection will be made with
Permit to be issued to lid qx"#'#+
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
- (Sig) Issued by 3wF
Tax Collector
Permit Fee: Paid $
INSPECTION:
INITIAL (Sig)
FINAL (Sig)
APPROVED � (Date)
(Sig)
CTOR
INSPE