HomeMy WebLinkAboutDrain Layers Permit 124 Mark Drive (2) f
r
10 N= OF SOUTH WINDSOR
DEPARTMENT OF POLLUTION CONTROL
B/P No.:
South Windsor, Connecticut
List,No.: _
DRAIN LAYER'S PERMIT 720
9 ..:
Pursuant to written applicatior; permission is hereby granted to the Licensed Drain?Layer named here!h.to:perform
the work indicated below at tip •on the
side -betw en
at premises owned by
whose address is
and to Lay House Drain, Repair House Drain, Lay Main, Other,
forI occupAncy:or use,
with Family, Units',._with sexes.
71
Type.of Sewage to be connected under this permit:
SANITARY SEWAGE INDUSTRIAL WASTES OR
Connection will be made with , "
Permit.to be'issued to
W..
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 he ermit arld-the reverse side
,thereof plicant has received Town.'Permit•No. and/or C H-D Permit No.
for street excavation. '
SPECIAL CONDITIONS
signed 'Ac '. n
Connection Charge Paid` ieense Drain Layer {
# Issued by # 41%
Tax Collector
Permit Nee:. Paid $
-INSPECTION: Check Number:
INITIAL '. r ""'.' (Sig)
FINAL _ '� .: rw. (Sig)
APPROVED lt. (Date)
r
(Sig) r,
IN$PEJ