HomeMy WebLinkAboutDrain Layers Permit 110 Margaret Drive TOWN OF SOUTH WINDSOR
DEPARTMENT OF POLLUTION CONTROL
B/P No.:
South Windsor, Connecticut
List No.: _
DRAIN LAYER'S PERMIT Ol
180
Gt/Lt��� � 19
(� M n
Pursuant to written applicatior, permission is'hereby granted to the
/Licensed Drain Layer named herein to perform
the work indicated below at /fin the
side, between /fin
at premises owned by 44,
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
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
r Signed
Connection rge Paid ( Y� Licensed'Drain Layer
Issued by
Tax Collector
Permit Fee: Paid $
INSPECTION: Check Number: __ 2Z
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
INSPECTOR =-