HomeMy WebLinkAboutDrain Layers Permit 274 Oakland Road TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL gip No.:
South Windsor, Connecticut
List No.: _
DRAIN LAYER'S PERMIT NO 3t34
'r, 19 v s
Pursuant to wNitten applicatior, permiss"ion ' hereby rante t the Licensed Drain Layer named herein to perform
the work indicated below at � on the
side, between
at premises owned by
whose address is r'
and to Lay House Drain, Repair House Drain, Lay Main, Other
for occupancy or use,
with Family Units, with acres.
04
Type of Sewage to be c nnected under th''s permit:
SANITARY SEWAGE ( j, INDUSTRIAL WAS ES .( ),�OR
�r vConnectiowwill be made with
f
Permit to be issued to Of
the holder of Drain}Layer's License No. Permit will expire on 19
The undersigned DraimLayer hereby, agrees to all the terms and conditions set forth on the permit affid the reverse side
thereof. Applicant has received Town Permit No. and/or C H D Permit No.
` for street excavation.
SPECIAL CONDITIONS
Signed a,4 ( o2o ax-5-
Conne Charge-Pa'd `z icensed Drain Layer
Issued by
Tag Collector
Permit Fee: Paid $/✓ �—S
INSPECTION: Check Number:
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
(Sig)
INSPECTOR
- t .