HomeMy WebLinkAboutDrain Layers Permit 480 Oakland Road TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL
South Windsor, Connecticut B/P No.: ,��
List No.: ` (w`/2
DRAIN LAYER'S PERMIT -
N° 133'7
Pursuant to written applicatior, permission is here granted to the c sed Drain Layer named herein to perform
the work 'ndicat below at ��n
10
side, between , e �. O n he
at premises owned
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
Connection Charge Paid _ �3 Licensed Drain Layer
- �d _20 —� � Issued by
Tax Collector
Permit Nee:. Paid $ _ S!0 U _
INSPECTION: Check Number: 7
INITIAL (Sig)
FINAL
(Sig)
APPROVED — (Date)
INSPE OR (Sig)
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