HomeMy WebLinkAboutDrain Layers Permit 11 Dawn Drive TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL
t South Windsor, Connecticut B/P No.:
List No.: _� 21
DRAIN LAYER',S PERMIT NO 1893
19
Pursuant to written applicatiorpemission is hereby granted to the Licensed Drain Layer named herein to"perform
the work indicated below at on the
side, between
at premises owned by—IL-A- V.
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 WASTE ( ), 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 verse side
thereof. Applicant has received Town Permit No. and/or C H D Permit No.
for street excavation.
SPECIAL CONDITIONS
Signed
Connection rge Paid 7V3 /G /� Licensed Dra' Layer
1 e- 4 0�
Issued by
Tax elector
Permit Fee:. Paid $
INSPECTION: Check Number:
INITIAL (Sig)
FINAL (Sig)
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