HomeMy WebLinkAboutDrain Layers Permit 273 LeFoll Boulevard TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL Bhp No.:
South Windsor, Connecticut
List No.: _
DRAIN LAYER'S PERMIT 'N? 2851
, 19 3
Pursuant to written applicatior, permission is hereby granted to t e Licensed Drain Layer named herein to perform
the work indicated below at ol�73 6V 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 ( 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 H D Permit No.
for street excavation.
SPECIAL CONDITIONS
Signed
Connect' arge Paid 3' �� Licensed Drain Layer
/Z�L/X� �OAOV.0, Issued by
Tax Collector
-" Permit Fee: Paid $
INSPECTION: Check Number: -
INITIAL (Sig)
FINAL (Sig)
(Date)
INSPECTOR