HomeMy WebLinkAboutDrain Layers Permit 20 Oak Street TOWN OF SOUTH WINDSOR
DEPARTMENT OF POLLUTION CONTROL
/ CONTROL
South Windsor, Connecticut B/P No.:
DRAIN LAYER'S PE RMI List No.:
T --__
° 2502
Pursuant to written applicatior' permission19�
,e work indicated below at r is hereby t
y granted to he
J Licensed Drain Layer named herein to perform
side, bet en
on the
at premises-owned by
whose address is n
and to -Lay House Drain,
for -Repair House Drain, Lay Main, _ Other
with
Family Units, with occupancy or use,
Type of Sewage to be connected under this permit.
SANITARY SEWAGE I acres.
( ), NDUSTRIAL WASTES .( ), OR (.
Connection will be made with
I
Permit to be issued to
the holder of Drain Layer's License No.
The undersigned Drain Layer hereby agrees to all the terms
• Permit will expire on
thereof. A and conditions set forth on the permit and the reverse side
pplicant has received Town Permit No.
for street excavation.
and/or C H D Permit No. '
SPECIAL CONDITIONS
�U,:S/
Connection Charge Paid Signed
Licensed Drain Layer
Tag Collector Issued by
Permit Fee:. Paid $
INSP,INSPECTION.
INITIAL CheckNumber: - --±�9d;�2, -
FINAL
APPROVED (Sig)
(Date)
INSPECTOR (Sig)