HomeMy WebLinkAboutDrain Layers Permit 398 Nevers Road TOWN OF SOUTH WI N DSOR
.s DEPARTMENT OF POLLUTION CONTROL
B/P No.:
South Windsor, Connecticut 0 Z
List No.:
DRAIN LAYER'S PERMIT N? 2132
9-3 , 19 �D
Pursuant to written applicatior, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at 3f S Pile,, on the
side, betweeen�'
at premises owned by t% ra Us�
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 416U Licensed Drain layer
0- Lxl- Issued by
Tax Cel4eeter 11 1 3 —Z
Permit Fee: Paid $ �0
INSPECTION: Check Number:
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
(Sig)
INSPECTOR
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9
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SOUTH W INOSOP a CjU_UTJC-N "CONTROL
LOCATION
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