HomeMy WebLinkAboutDrain Layers Permit 191 McGrath Road (2) F.
TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL B/P No.:
South Windsor, Connecticut
List No.: _
DRAIN LAYER'S PERMIT NO 3206
W�4 /(O , 19
Pursuant to written appli at�io�r, permission is h r by -ante Licensed Drain Layer named herein to perform
the work indicated below at OA t
on the
1'
side, between
at premises owned by L{1�2r-
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 CQNDITIONS
(2
Signed
Connection Charge Licensed Drain Layer
- Issued b
Tax Collector y
Permit Fee:. Paid $ _��!.0y
INSPECTION: Check Number:
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
(Sig)
INSPECTOR