HomeMy WebLinkAboutDrain Layers Permit 136 Mark Drive TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL
B/P No.: _
South Windsor, Connecticut
List No.: _
DRAIN LAYER'S PERMIT N? 3050
Pursuant to written applicatior, permission is hereb ranted to the Licensed Drain Layer named herein to perform
the work indicated below at 1 3 6 / / -44 1 .1 on the
side, betty n
at premises owned byd-
whose address is
and to Lay House'Drain, Repair House Drain, Lay Main, Other
for occupancy or use,
with 4Q�XFamily Units, with acres.
Type of Sewage to be connected under this permit:
SANITARY SEWAGE ), INDUSTRIAL WASTES . ),,OR
Connection will be ma a with
Permit to be issued to
r
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
wz.�.Z4
Signed
Connection ge PaidOY�/d y/ �'3 is sed Drain Layer
Issued by
Tax Collector
�L
Permit Fee: Paid $ _ �4 If-
INSPECTION: Check Number: --a d-7
INITIAL (Sig)
FINAL (Sig)
APPROVED �� Z�ji �� (Date)
(Sig)
INSPECTOR