HomeMy WebLinkAboutDrain Layers Permit 11 Mara Trail TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL
South Windsor, Connecticut B/P No.:
List No.: _
DRAIN LAYER'S PERMIT N? 2776
J1 M&A 1-- , 193
Pursuant to written applica'tiJor, permissiop is hereby grant d to the Licensed Drain Layer named herein to perform
the work indicated below ate?
on the
side, between/
at premises owned by_ ,/&11.p
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
-cf3
Signed
Connection Charge Paid Licensed Drain Layer
Issued b
/ Tax Collector y
Permit Fee: Paid $ Gy
-
INSPECTION: Check Number: dG
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
(Sig)
INSPECTOR