HomeMy WebLinkAboutDrain Layers Permit 71 Juniper Lane TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL
South Windsor, Connecticut B/P No.:
List No.:
DRAIN LAYER'S PERMIT -
N° 1529
91 ZIA*Al U rU N e v�wi I , 19 -7s
Pursuant to written applicatior, permission is hereby granted to the Licensed Drain-Layer named herein to"perform
the work indicated below at V" h ( G V pt�a'r S
on the
side, between
at premises"owned
and to Lay House Drain, Repair Housp Drain, Lay Main, 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 ( )
Connection will be made with
Permit to be issued to V_ .h
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
Issued by
Tax Collector
o�
Permit lace:. Paid $ _
INSPECTION: Check Number:
INITIAL (Sig)
FINAL
(Sig)
(Sig)
.;
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