HomeMy WebLinkAboutDrain Layers Permit 83 Murray Road TOWN OF SOUTH Wi N DSOR
DEPARTMENT OF POLLUTION CONTROL
South Windsor, Connecticut B/P No.:
List No.: _
DRAIN LAYER'S PERMITO 2626
19—SLR
Pursuant to written applicatior, a ission is hereby, ranted to the Licensed Drain Layer named herein to perform
the work indicated below at 0 0i
on the
side, betty en
at premises owned by yL j e 1 n
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
4ponnection Charge Paid 8�3 I e� Licensed Drain Layer
42 Issued by
�a Collect r'
7
Permit Fee:. Paid $
INSPECTION: Check Number:
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
(Sig)
INSPECTOR