HomeMy WebLinkAboutDrain Layers Permit 55 Laurel Street (2) TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL
South Windsor, Connecticut B/P No.: —
List No.: _
DRAIN LAYER'S PERMIT Np 2609
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Pursuant to written applicatior, permiss' is hereby anted to the Licensed Drain Layer named herein to perform
the work indicated below at
on the
side, betwee
at premises owned by
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 ( ), 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 I
The undersigned Drain Layer her
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
[,I Signea
Connect' harge Paid / 11' $� Z� Licensed Drain Layer
Tax Collector
Issued by
Permit Fee:. Paid $ =�Z- 2_
INSPECTION: Check Number: _
INITIAL (Sig)
FINAL (Sig)
APPROVED
(Sig)
INSPECTOR - - - -- - -. _ _ -- -- -