HomeMy WebLinkAboutDrain Layers Permit Nutmeg Road North (3) TOWN OF SOUTH WINDSOR
DEPARTMENT OF POLLUTION CONTROL
South Windsor, Connecticut B/P No.:
List No.: _
DRAIN LAYER'S PERMITS 3094
Pursuant to written ap licatior, ermission is hereby granted to the Licensed Drain La er named herein to perform
the work indicated below at
on the
side, b tween
at premises owned by C_
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 ishued 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 �-
v ` Signed
Connection Charge Paid 0 b 0 i`/- g _49Licensed Drain Layer
Issued by
&AC olletj
�Q Permit Fee: Paid $
INSPECTION: Check Number:
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
INSPECTOR (Sig)