HomeMy WebLinkAboutDrain Layers Permit 1047 Main Street - TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL B/P No.:
South Windsor, Connecticut
List No.: _
DRAIN- LAYER' S PERMIT ND 2573
Qzot& , 19 �
Pursuant to written applicatior, permission is hereby granted to the Licensed Drain Layer named,herein to perform
the work indicated below at a4-1 on the
side, betwe
�..�,
at premises owned by—
whose address is
and to Lay House Drain, Repair House Drain, Lay Main, Other ,
for occupancy or use,
with 4Q21gFamily Units, with
� acres.
Type of Sewage to be connected under this permit: ��n
SANITARY SEWAGE X), INDUSTRIAL WASTES ( ), OR
Connection will be made with
Permit to be issued to I 't
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.
SP CIAL G NDITIONS
ON
:r
Signed lL2— `
Connection Charge Paid License Drain Layer
Issued by
K.YL-I-P Tax Collector
Permit Fee: Paid $
INSPECTION: Check Number: r
INITIAL (Sig)
FINAL (Sig)
APPROVED 00 (Date)
(Sig)Tom. -
INSPECTOR