HomeMy WebLinkAboutDrain Layers Permit 70 Meryl Road (2) TOWN OF SOUTH W1 N DSOR
DEPARTMENT OF POLLUTION CONTROL B/P No.:
South Windsor, Connecticut
List No.: _
DRAIN LAYER'S PERMIT N° 2551
Ina,
Pursuant to written app/l}icatiorr,,ypermissio is,hereby anted to the Licensed Drain Layer named herein to perform
the work indicated below at %O / / ) on the
side, betty n
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 (, 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 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 � Q Licensed Drain Layer
2'�3: 2 ( --t tM Issued by
Tax Collector J
Permit Fee: Paid $ _In,
INSPECTION: Check Number: / �
INITIAL (Sig) C �—
FINAL (Sig)
APPROVED (Date)
(Sig)
INSPECTOR