HomeMy WebLinkAboutDrain Layers Permit 239 LeFoll Boulevard 6 - _ w- ,.
TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL
South Windsor, Connecticut B/P No.:
List No.: _
DRAIN LAYER'S PERMIT NO 2733
Pursuant to written applicatior, permission is hereby granted to thpLicensed Drain Layer named herein to perform
the work indicated below at on the
side, between T
at premises owned by J
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 C ge Paid ' Licensed Drain Layer
as Collector Issued by
Permit Fee:. Paid $
INSPECTION: Check Number: _
INITIAL (Sig)
FINAL (Sig)
PROVED (Date)
INSPECTOR -_(Sig) - -. -- - --
--