HomeMy WebLinkAboutDrain Layers Permit 93 Murray Road TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL
B/P No.:
South Windsor, Connecticut 3a�Q O 7
List No.: _
DRAIN LAYER'S PERMIT NO 2127
14-0
Pursuant to written applicatior, permission is hereby granted to the icensed Drain Layer named herein to perform
the work indicated below at on the
side, between at premises owned by / —M!)A , G()a/ a e P /Vol f
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
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 yd d Licensed Draia Layer -m
.Wail;
Issued by
Tax Collector & a S
P rmit Fee: Paid $ _�S=��
INSPECTION: Check Number: 3y�'
INITIAL (Sig) zallleY/
FINAL (Sig)
APPROVED (Date)
INSPECTOR (Sig)
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