HomeMy WebLinkAboutDrain Layers Permit 210 Margaret Drive TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL
B/P No.: _
South Windsor, Connecticut
List No.: _
DRAIN LAYER'S PERMIT NO 2875 ,
19 �'
Pursuant to written applicatior, permission is hereby granted to theLicensed Drain Layer named herein to perform
the work indicated below at 7f V r(, D r' on the
side, between _
at premises owned
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
Z Signed
Connection Ch Paid ✓� / Licensed Drain Layer
Issued by
Ta ollector
Permit Nee: Paid
INSPECTION: Check Number: ��6
4t
INITIAL (Sig)
FINAL (Sig)
.fir
APPROVED (Date)
.r .
(Sig)
INSPECTOR
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