HomeMy WebLinkAboutDrain Layers Permit 118 Oakland Road TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL
B/P No.:
South Windsor, Connecticut
List.No.: _
DRAIN LAYER'S PERMIT N� 3061
Pursuant to written app/li,aaitio, ermvjision is here/b� gr nted to the Licensed Drain Layer named herein to perform
the work indicated below at /l U 6t . a4 d—rX
on the
side, b Itleen
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
h `" ( Signed
g u �
onnection Charg�3%
aid 60. 0 t) �c 4V3 l Licensed Drain Layer
t,ICQ� IF avuz— Is/sued by
T olle tqnr n /
t' Permit Fee: Paid $ _1_ ^�0 0
INSPECTION: Check Number:
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
(Sig)
INSPECTOR