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HomeMy WebLinkAboutDrain Layers Permit 24 Mara Drive TOWN OF SOUTH WI N DSOR DEPARTMENT OF POLLUTION CONTROL South Windsor, Connecticut B/P No.: List No.: DRAIN LAYER'S PERMIT N? 2925 19 ,E Pursuant to written app,icatior, permission is hereby ranted to the Licensed Drain Layer named herein to perform the work indicated below at j /2 �k`1' i on the t r side, between at premises owned by l/ 'F r. 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 ( 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 H D Permit No. for street excavation. SPECIAL CONDITIONS Signed Connection Charge Paid 0 Licensed Drain Layer Issued by y,�ax Collector j� Permit Fee:- Paid $ _ 45Y_o INSPECTION: Check Number: 7 9e�- INITIAL (Sig) FINAL (Sig) APPROVED (Date) INSPECTOR (Sig)