HomeMy WebLinkAboutDrain Layers Permit 175 Krawski Drive TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL B/P No.:
South Windsor, Connecticut
List.No.: _
/ rpS�� DRAIN LAYER'S PERMIT O
ins N. 3563
- \ J�17 , 19
Pursuatk to irr1ter,ap li��atior, permiss'on Js here granted to the Licensed Drain Layer named herein to perform
the work indicated below atILI on the
l side, be ween
at remises owned b
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 Sewagf atb , nXec?Q under this permit:
SANITARY SEWAGE { ), INDUSTRIAL WASTES ( ), OR ( )
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
5-7 (,/ Signed
C nnection Charge Paid d �. Q D G ! l Licensed Drain Layer
� . � a2kIssued by
Coll c or _
1
Permit Fee: Paid $ b
INSPECTION: Check Number.: j G
INITIAL (Sig)
FINAL (Sig)
APPROVE (Date)
INSPECTOR