HomeMy WebLinkAboutDrain Layers Permit 260 Oak Street TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL
• South Windsor, Connecticut B/P No.:
List No.: _
DRAIN LAYER'S PERMIT N? 2525
Pursuant to written applicatior, permiss�gon i�sj here y granted to the Licensed Drain Layer named herein to perform
the work indicated below at on the
side, between
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 ( ), 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
Aonnectio harge Paid_ Z— Licensed Drain Layer
Issued by
Tax Collector
�l
_ Permit Fee:. Paid $ _�✓�___-S �Z-
INSPECTION: Check Number: v2 s
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
INSPECTOR (Sig)