HomeMy WebLinkAboutDrain Layers Permit 6 Murielle Drive TOWN OF SOUTH WI N DSOR
DEPARTMENT OF. POLLUTION CONTROL B/P No.:
South Windsor, Connecticut tl Q
List.No.: _
DRAIN LAYER"S PERMIT NO 1244
- 3
19 ��
Pursuant to written applic tior, permission i reby granted to the Licensed Dramayer namedherein t+ Vorinthe work indicated low at �� / �1` / 7Ufthe
side, between
UT�!' r ' 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 (X), INDUSTRIAL W STES ), OR ( )
Connection will be made with—
Permit 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 Pe t No.
for street excavation. /
SPECIAL CO ION
/ Q& "
Signed
Connection Charge Paid Lice d Drain Layer
(�—)— < ,7 Issued by
Tax Collector
Permit Fee:. Paid $ _ V y
INSPECTION: Check Number:
INITIAL (Sig)
FINAL (Sig)
APPROVED n / (Date)
J
(Sig)
- ECTOR