HomeMy WebLinkAboutDrain Layers Permit 186 Kelly Road r
` = OWN 70F SO TH WI N DSOR' t
-
t DEPARTMENT OF POLLUTION CONTROL
r South Windsor, Connecticut
DRAIN LAYER'S PERMIT
O 295
19
Pursuant to written application, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at 1* ' on the
side, between
.
at premises owned by—
whose address is
and to Lay House Drain, Repair House Drain, Lay Main, Other ,
for J, occupancy or use,
with Family Units, with acres.
Type of Sewage to be connected under this permit:
SANITARY SEWAGE,' INDUSTRIAL WASTES, OR
�q
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 1) Permit No.
for street excavation.
SPECIAL CONDITIONS
Signed
Connection Charge Paid; ,'. _ Licensed Drain Layer
w ,
(Sig) .'Issued by
Tax Collector
Permit Fee: Paid $ ,``;
INSPECTION:
INITIAL ) (Sig) ..
FINAL 114 Ir (Sig)
APPROVED 1' ✓ 42 OZZ? S (Date)
(Sig)
INSPECTOR