HomeMy WebLinkAboutDrain Layers Permit 114 Laurel Street TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL
South Windsor, Connecticut BAP No.: q
List No.: _ 3 a' U l
DRAIN LAYER'S PERMIT p 2139
1
19
Pursuant to written applicatior, per, sion�is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at
on the
side, between
Olt premises owned by d
•r.
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.SEWAGE ( j, INDUSTRIAL WASTES .( ), OR ( )
Connection will be made with
Permit to be issued to
the holder of Drain Layer's License No. a
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.
for street excavation. and/or C H D Permit No.
SPECIAL CONDITIONS
Signed
Xnerg�42d
Licensed Drain Layer
1 Issued by
Permit Fee:. Paid $
1 INSPECTION: Check Number:
INITIAL (Sig)
FINAL
(Sig)
c :
APPROVED
INSPECTOR---- `. (Sig)
lb
1
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