HomeMy WebLinkAboutDrain Layers Permit 43 Nancy Drive TOWN { F SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL
B/P No.:
� South Windsor, Connecticut•� I List No.: _
DRAIN LAYER'S PERMIT
O 2513
V e,
Pursuant to written applicatior, permiss n is hereby.granted to the Licensed Drain Layer named herein
m to perform
the work indicated below at �-�/ ' on' ' on the
side;'Between /1
at premises owned by .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 "
( j, 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 acid condiiioas set forth'on the permit and the reverse side'
thereof. Applicant has received Town Permit No. and/or C H U Permit No.
for street excavation.
SPECIAL :CONDITIONS
Gt Signed
Connection a Paid (J�l1 ✓ FZ_ Licensed-Drain Layer
Issued by
Tax Collector
Permit Fee: Paid $
INSPECTION: Check Number:
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
u
(Sig)
INSPECTOR