HomeMy WebLinkAboutDrain Layers Permit 182 Oak Street TOWN OF SOUTH WINDSOR
DEPARTMENT OF POLLUTION CONTROL
� .t South Windsor Connecticut
DRAIN LAYER'S PERMIT N.O
305
CL
. , k ' 19
Pursuant to written application sion 's hereby granted to the Licensed Drain Layer named herein to perform
AR
the work indicated below at t, on the
Li �ew en
�d v
at premises owned by _ t
whose address is
and to �� Lay House Drain, Repair House Drain, Lay Main, Other
for
occupancy or use,
with -A 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 ` P,4
4.
7�1
�
Signed
Connection Charge Paid $ Licensed Drain Lgiyel
Tax Collector (Sig) Issued by
Permit Fee: Paid $ `
INSPECTION: '
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
INSPECTOR (Sig)