HomeMy WebLinkAboutDrain Layers Permit 895 Main Street TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL B/P No.:
South Windsor, Connecticut �`
List No.:
DRAIN LAYER'S PERMIT O
�1T. 240'7
19 F)
Pursuant to written applicatior, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at P6 on the
side, betty n
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 SEWAG ' INDUSTRIAL WASTES ( ), OR ( )
Connection will be mg de th
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
a� ��
f 9&`,l Signed
Connection Charge Paid yja ��(� Licensed Drain Layer
,Z&w (- ``�C
Issued by
Tax Collector
Permit Fee:. Paid $ _,9:5��V__
INSPECTION: Check Number:
W�
INITIAL (Sig)
FINAL (Sig)
—_ --------- APPROVED - -- - -- - (Date)
- Y
(Sig)
INSPECTOR
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1
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DOTES SOUTH tJINDSOR POLLUTION CONTROL
LOCATION
OWNEP.
TYPE Or WORK
DATE t ER2�iIT PPE ". yr
INSTAL?FR
INSPECTOR DRAWN BY �,