HomeMy WebLinkAboutDrain Layers Permit 195 LeFoll Boulevard TOWN Of SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL Bhp No.:
South Windsor, Connecticut
List No.: _
DRAIN LAYER'S PERMIT N? 2804
l ' 19 O
Pursuant to written ap licatior, permission is
her`ebv /rain/t to the Licensed nDrain Layer named herein to perform
the work indicated below at 77 -1 (5 on the
side, between
t�
at premises owned by V• !�5
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. 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 13 D Permit No.
for street excavation.
SPECIAL CONDITIONS
da7-7
Signed
Connection Charge Paid C)D, (} �-D �J� 1 A13 -Licensed Drain Layer
0 It Issued by
a t Callectqf�
Permit Fee: Paid $
INSPECTION: Check Number:
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
(Sig) -
INSPECTOR