HomeMy WebLinkAboutDrain Layers Permit 617 Nevers Road (2) TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL
_ B/P No.:
South Windsor, Connecticut
List No.: _
DRAIN LAYER'S PERMIT NO 2168
190
Pursuant to written appEcatior, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at on the
side, between
at premises owned by /7
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 i
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
C nne lion Charge Paid Licensed Drain Layer
Issued by
Tax CaUester
Permit Fee:. Paid,$ �-S
INSPECTION: Check Number:
INITIAL (Sig)
�J I�• /Cy1SIir.��7►i�n� .
FINAL (Sig)
APPROVED (Date)
INSPECTOR (Sig)