HomeMy WebLinkAboutDrain Layers Permit 38 Lewis Drive TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL
B/P No.:
South Windsor, Connecticut
List.No.: _
DRAIN LAYER'S PERMIT NO 1664
19
Pursuant to written applicatior, per ion is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at ��.��� �/lt/,,� on the
side, between
at premises own d b
whose address is
and to House Drain, Repair House Drain, Lay Main, _rOther
for occupancy or use,
with G? Family Units, with acres.
Type of Sewage to be connected under this permit:
SANITARY SEWAGE ( o ), INDUSTRIAL WASTES .( ,IOR ( )
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 2- -7V
Licensed Drain Layer
Issued by —75e�
Tax Collector
ov
Permit Fee: Paid $
INSPECTION: Check Number: ®
INITIAL (Sig)
FINAL (Sig)
-- APPROVED-- - - - -- - --- -- - (Date) --- .� -7111-7 ct
INSPECTOR (Sig) �,..
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