HomeMy WebLinkAboutDrain Layers Permit 60 Meryl Road (2) TOWN OF SOUTH WINDSOR
DEPARTMENT OF POLLUTION CONTROL
South Windsor, Connecticut B/P No.: _
i
List No.: _
t
DRAIN LAYER'S PERMIT Np 23 9
19�
Pursuant to written applicatior, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at
on the
side, bet n
at premises owned byJr-
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: `,.s
SANITARY SEWAGE { ), INDUSTRIAL WASTES .( ), OR ( ) —
Connection will be made with
a
Permit to be issued to
the holder of Drain Layer's License No.
Permit will expire on 19 Aµ+
set forth on the permit and the reverse side
The undersigned Drain Layer hereby agrees to all the terms and conditions
thereof. Applicant has received Town Permit No. and/or C H'D Permit No.
for street excavation.
SPECIAL CONDITIONS
_ Signed
Connect' harge Paid j Licensed Drain Layer
Issued by
Tax Collector
Permit Fee: Paid $
INSPECTION: Check Number: r�
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
(Sig)
INSPECTOR