HomeMy WebLinkAboutDrain Layers Permit 177 Laurel Street (2) TOWN OF SOU 'H WI N DSOR
DEPARTMENT OF�POLLUTION CONTROL
-South Windsor, Connecticut
S-GO 11 Al
DRAIN LAYER'S PERMIT
O 365
19
y�
Pursuant to written application, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at on the
»M side, between
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 withSAW
Permit to be issued to JWhK
the holder of Drain Layer's License No. "4" 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..!, r r v
Connection Charge Paid 4"" ~Licensed Drain Layer
so No" (Sig) Issued by bbb A* S A**-
Tax Collector
Perm Raid 8
INSPECTION: W&1 0 ' '�'
INITIAL V (Sig)
FINAL (Sig)
ate
— - --- -,_ _ (Sig).
INSPECTOR -