HomeMy WebLinkAboutDrain Layers Permit 235 Orchard Hill Dri OWN OUTH WI N DSOR
DEPARTMENT OF POLL TION CONTROL_ B/P No:: ,
South Whidsor, Connecticut
List. No.:
DRAIN LAY;ER'7S, P5RMIT Grp 640
' So im 19
Purs'nat Co writrerF aplicator, permiss"ion'is hereby granted to the Licensed Drain"Layer named herein to perform
the.work indicated"below at 40M
on the
side, between
at premises owned by '
whose address isYX
and So Lay House'"Drain, "Repair House'Drain, Lay Main, Other
for ,^ occupancy or use,
with ; Famiy-ITnitss.:w,tthf.:°; acres.
Type of Sewage to bey cenngeted under:phis permit:
.� SANITA Y SEWAGE ( ), INDUSTRIAL WASTESjf
s — !
Connection will be made with
IMAL
_Pefrgit to,beued to J
the holder of,Drain Layer's License Noy' 'Permit will ex )ire-rgn' 19
The.undersigned Dratri"Laygr hetetiy agrees to all the terms and:conditions set forth�on the permit and the reverse side
thereof.' Applicant has,received_Town°Permit No.' anilor C'`H D Permit No.
foi•'street excavation.
SPECIAL CONDITIONS _
Signed49 Connection Charge Paid . Licensed Drain ayes '
Issued by t�`� !
Tax Collector` '
Permit .Fee:. Pitid'�
INSPECTION: Check Number: .
INITIAL (Sig)
-" FINAL (Sig)
J AP
APPROVED - (Date)
(Sig)
INSPECTOR -
r: