HomeMy WebLinkAboutDrain Layers Permit 25 Mohegan Trail (2) A �
'OWN OF SO WINDSOR
..._ DEPARTMENT OFbLLUT10N ..CONTROL .
x B/P No.'
South Windsor, Connecticut
List No.:
a r - DRAIN LAIFER'S PERMIT
119
T • f��ll� R
Pursuant to written applicatior, permission is'hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at _6 AN on the
side, between
at"premises owned
whose address is
and to A Lay House Drain Repair House Dral`n, Lay Main, Other
for
occupancy or use,
with
Family Units;w th acres.,
Type of Sewage to.be connected under this permit:
;SANITARY_SEWAGE'(X ), INDUSTRIAL WASTES OR
Connection will be made with
" Permit to be issued to
d •holder of Drain 'La ers License No
Y '�+ Permit will expire on; � 19
Thy undersigned Drain Layer hereby agrees to all the terms and conditions set forth on the
r pe milt an 'the reverse side - -
' thereof. 'Applicant has receivedTown Permit No. and/or C H D"Permit No
for iitreet excavation.
SPECIAL CONDITIONS;
v -
Signed
Connection Charge Paid --Licensed Drain Layer
Issued by
Tax Collector F
Permit Fee:. Paid $ ,
INSPECTION: Check Number:
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
(Sig)
INS15EOTOR