HomeMy WebLinkAboutDrain Layers Permit 1209 Main Street DEPARTMENT OF POLLUTION CONTROL B/P No.:
South Windsor, Connecticut
List No.: _
DRAIN LAYER'S PERMIT NY 54
19 gL
Pursuant to written ap lhicati(o�r, per fission is 1wreby granted to the Licensed Drain Layer named herein to perform
the work indicated below at O V I /n
on the
side, b tween
—,qt premise -
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
Connect-ion 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.
s for street excavation.
SPECIAL,.CONDITIONS
Signed
nnection Charge Paid#' Q- U y Licensed Drain Layer
Issued by
m - : Collects
Permit Fee: Paid $
INSPECTION: Check Number:
INITIAL (Sig)
--- - FINAL (Sig)
APPROVED (Date)
- -(Sig) - -
INSPECTOR _