HomeMy WebLinkAboutDrain Layers Permit 200 Orchard Hill Dri (2) i
v TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL
B/P No.: •
South Windsor, Connecticut , "
List.No.: _
olo 13
DRAIN LAYER'S PERMITp_ 767
bo
0 1�$ pn$ is* 74 119
Pursuant to written applicatior, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below_at } 'S on the
side, between
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 SEW-AGE (I), INDUSTRIAL WASTES .( ), ORsix b
( )
Connection will be made with
Permit to'be issued to to
the holder of,Dram La ,er's Licen§e No. Permit will-,expire on 19
The undersigned Drain'Layer hereby agrees to all the terms and conditions'setforth on the permit'and the reverse side
i;
thereof: Applicant has'received Town Permit No. and/or C H D Permit No.
for street excavation.
SPECIAL CONDITIONS
T 5
t l {
nea Si f � M
g
Connection Charge Paid Licensed ,rain Layer,
(r f# Issued by 1 #t
Tax Collector
Permit Fee:. Paid $
INSPECTION: _ Check Number:
INITIAL - (Sig)
FINAL (Sig)
APPROVED - i �� ! _.... .. . (Date)
FINS .:. OR (Sig)