HomeMy WebLinkAboutDrain Layers Permit 1425 Main Street TOWN OE SOUTH . WI N:DSO[
B/P No.:
South Windsor, Connecticut 3�6
List No.-
DRAIN LAYER'S PER M I
2125
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Pursuant to written applicatior, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at on the
side, between
at premises owned by �i�fi�G� Gui'lGy� l24461 GN i r
whose address is
and to Lay House Drain, Repair House Drain, Lay-Main, Other t
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 HD Permit No. '
for street excavation.
SPECIAL CONDITIONS
UO Signed
Connection Charge Paid ��„ Licensed Drain Layer
,:.� -issued by
Tax Collector
Permit Fee: Paid $
INSPECTION: Check Number: _e
INITIAL (Sig) SA9 -e7L � \
FINAL . (Sig)4
APPROVED
ate)
" (Sig)--
INSPECTOR --