HomeMy WebLinkAboutDrain Layers Permit 141 Margaret Drive TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL
B/P No.:
South Windsor, Connecticut
List No.: _
DRAIN LAYER'S PERMIT O 3479
141 MaA �f
Pursuant to written TO-1
plicati/orr,I permi lion is hereby ranted to the Licensed Drain Layer named herein to perform
the work indicated below at /0 1Pdj ad4z —
on the
side, bet to
at premises owned by J.t`�1 .J
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 Licensed Drain Layer
fIssued by
f of
Permit Fee: Paid $2_ tT.D
INSPECTION: heck Number: J��
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
INSPECTOR (Sig)