HomeMy WebLinkAboutDrain Layers Permit 50 Meryl Road (2) TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL
B/P No.:
South Windsor, Connecticut
List No.: _
DRAIN LAYER'S PERMIT NO 2397
19r
Pursuant to written applicatior, permission is hereby gran te t the Licensed Drain Layer named herein to perform
the work indicated below at on the
side, between
at premises owned by—
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
i;
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 CONDITIONS
Signed
Connection Charge Paid Ybd Licensed Drain Layer
Issued by
Tax Collector
UU
Permit Fee Paid $ _ S
INSPECTION: Check Number-: S_
INITIAL (Sig)
FINAL (Sig) \\
APPROVED (Date) C�Ps CLJ
(Sig)
INSPECTOR
NOTES SOUTH 14INDSOR POLLUTION, COTUROL
LOC?T zort
TYPE 0r WORK
DATE 'T- lcl-- e�)"1 PER fxT t J 7 PIPE
INSTH t.FR r
INSPECTOR DRAWN BY `.