HomeMy WebLinkAboutDrain Layers Permit 25 Murray Road (2) t VNN OF SOUTH WI N DSOR
r DEPARTMENT OF POLLUTION CONTROL
B/P No.: i!
South Windsor, Connecticut
List.No.:
DR-AIN LAYER'S PERMIT p 555 '
Pursuant to written application;,permission is hereby gianted to the Licensed Drain Layer named herein to-perform
the work indicated below at on the
At side, betwe
at.premises owned by_ 96 Mm '
whose address is !
and to Lay House Drain, Repair House Drain, Lay-Main, Other
for fliitl �IliiR
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
;W tot
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 sid"e
thereof. Applicant has received Town Permit No. and'/or C H D Permit No.
for street excavation.
SPECIAL CONDITIONS
A"Wh AWL Signed V
Connection Charge Paid Licensed Drain Layer
y
Tax Collector � " Issued
Permit Fee:. Paid $
INSPECTION: Check Number:
f s
INITIAL > ..--... (Sig)
•FINAL
(Sig)
APPROVED (Date)
1
e: ^;-,r-
(Sig) .
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