HomeMy WebLinkAboutDrain Layers Permit 149 Oak Street (2) TOWN OF SOUTH WINDSOR
DEPARTMENT OF 1POLtUT10N CONTROL
South Windsor, Connecticut Ll
DRAIN LAYERS PERMIT 0 409
Pursuant to written application, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at'I" t ie S!_ on the
%lilt side, between L JkOCAM"
at premises owned b � B�
Y
whose addresslli�IlM!
and to x Lay House Drain, Repair House Drain, Lay Main, Other
for occupancy or use,
with Me (1) Family Units, with acres.
Type of Sewage to be connected under this permit:
SANITARY SEWAGE, INDUSTRIAL WASTES, OR
Connection will be made with Ift 12" (16) j0jM$ ,!
Permit to be issued to
the holder of Drain Layer's License No: u Permit will expire one 1
The undersigned Drain Layer hereby agrees to all the terms and conditions set forth on the permt�and the reverse 9RIe
thereof. Applicant has received Town Permit No. and/or C H D Permit No.
for street excavation.
SPECIAL CONDITIONS VrAft UM tO rMs !ice OW b"k= met"
Signed
Connection Charge Paid Licensed Drain Layer
ftr* so l (Sig) Issued by FAdD* A* 8 thy: is
Tax Collector
Permit Fee: Paid
INSPECTION:
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
`7... �"` � ./f - J•INSPECTOR (Sig)