HomeMy WebLinkAboutDrain Layers Permit 21 Marty Lane TOWN OF SOUTH WINDSOR
DEPARTMENT OF POLLUTION CONTROL
South Windsor, Connecticut Li B/P No.:
� st No.: _
0 DRAIN LAYER'S PERMIT
'p 270
y
Pursuant to written appli atior, permissio is hereby granted the Licensed Drain Layer named herein to perform
the work indicated below at r`Z '
on the
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 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
Signed
Connection Charge Paid / 0O.DU Licensed Drain Layer
�l�(J9-fiu
Issued by
Tax Collector
Permit Fee: Paid $
INSPECTION: Check Number:
INITIAL (Sig)
FINAL (Sig)
APPROVED
(Sig)
INSPECTOR _