HomeMy WebLinkAboutDrain Layers Permit Nutmeg road North (4) ., .a ,,,111.11 ,,.-- .., -. 4 _.. -- 'ram
TOWN OF SOUTH WINDSOR
DEPARTMENT OF POLLUTION CONTROL
B/P No.:
South Windsor, Connecticut
List No.: _
DRAIN LAYER'S PERMIT N00
94
N C)
Pursuant to written ap licatior, ermission is hereebb� granted to-the Licensed Drain La er named herein to perform
the work indicated below at .a��f/l�¢-+lX /� J� ('--A on the
side, b weep )
at premises owned by
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 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 f O.0 D. D D (I` Licensed Drain Layer
Issued by
a x Coll t r " b-
Permit Fee: Paid $ _I O
INSPECTION: Check Number:
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
INSPECTOR (Sig)