HomeMy WebLinkAboutDrain Layers Permit 55 Old Farm Road TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL B/P No.:
South Windsor, Connecticut '5;'O 7d
List No.: _
DRAIN LAYER'S PERMIT N? 2190
99 , 19�
Pursuant to written applicatior, permission is hereby granted to the Lic se n Layer named herein to perform
the work indicated below at "vN
on the
side, between
at premises owned by— SUv r1
whose address is
and to Lay House Drain, Repair House Drain, Lay Illain, Other
for
occupancy or use,
with AFamily 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
119 _ Signed
Conction Charge Paid �Q� Licensed Drain Layer
` Issued by
Y> � Tax Collector
#a t 71)
Permit Fee: Paid $
INSPECTION: Check Number:
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
t
(Sig)
INSPECTOR
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