HomeMy WebLinkAboutDrain Layers Permit 201 Margaret Drive TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL
South Windsor, Connecticut B/P No.:
List No.: _
DRAIN LAYER'S PERMIT Np 3000
� .. � 19 �
Pursuant to written applicatior, permission is hereb granted to the Licensed Drain Layer named herein to perform
the work indicated below at '
' on the
side, between
at premises owned by+4
whose address is
and to Lay House Drain, Repair House Drain, La i
Y Man 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 1
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-M(--,Id Licensed Drain Layer
-Tag Collector Issued by
Permit Fee:. Paid $ _ Oy
INSPECTION: Check Number: �a�U
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
INSPECTOR (Sig)