HomeMy WebLinkAboutDrain Layers Permit 32 Mara Drive TOWN OF SOUTH WINDSOR
DEPARTMENT OF POLLUTION CONTROL
B/P No.:
South Windsor, Connecticut^
List No.: _
DRAIN LAYER'S PERMIT *j0 3064
, 19 (f 3
Pursuant to written applicatior, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at ?7 k OZ �^ on the
side, between
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 acresAJ
Type of Sewage to be connected under this permit:
SANITARY SEWAGE ( ), INDUSTRIAL WASTES .( ), OR ( j
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
Connectio _C- rge Paid Licensed Drain Layer
Issued by
� Tax Collector
Permit Fed:. Paid $ _�.S £S 3
INSPECTION: Check Number:
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
INSPECTOR (Sig)
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