HomeMy WebLinkAboutDrain Layers Permit 171 Margaret Drive TOWN OF SOUTH WINDSOR
DEPARTMENT OF POLLUTION CONTROL
South Windsor, Connecticut B/P No.:
List No.: _
DRAIN LAYER'S PERMITp
2882
, 19 if&
Pursuant to written applicatior, ermission is lWreby granted to the Licensed Drain L yet named her the work indicated below at 3 herein to perform
side, between on the
-
_. _
at premises owned by
whose address is
and to Lay House Drain, Repair House Drain,
Lay-Main, Other
for
with occupancy or use,
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.
The undersigned Drain Layer hereby agrees to all the terms and conditions s tlfor heron he permit and the reverse side thereof. Applicant has received Town Permit No.
for street excavation. and/or C H D Permit No.
SPECIAL CONDITIONS
Connectio arge Paid Signed
Licensed Drain Layer
4Tax Collector Issued by
Permit Fee:. Paid
INSPECTION: Check Number:
INITIAL
(Sig)
Sig)
APPROVED (Sig)
(Date)
INSPECTOR (Sig)