HomeMy WebLinkAboutDrain Layers Permit 193 Norton Lane TOWN OF SOUTH WINDSOR
DEPARTMENT OF POLLUTION CONTROL
B/P No.:
South Windsor, Connecticut
List.No.:
DRAIN LAYER',S PERMIT NO 1596
Pursuant to written applica/tior, permission is hereby granted to the Lic/fined Drain ayer named herein to perform
the work indicated below at on the
17 A N Q D h side, between
at premises owned by �1�
whose address is
and to Lay House Drain, Repair House Drain, Lay-Main, Other
for o.L,� _occupancy or use,
with g Family Units, with acres.
Type of Sewage to be connected under this permit: zye— w f
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 0 C) Licensed Drain Layer
ZIssued by
Tax Collector
Permit Fee: Paid $
INSPECTION: Check Number:
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
INSPECTOR (Sig)