HomeMy WebLinkAboutDrain Layers Permit 73 Orchard Hill Driv TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL BAP No.:
South Windsor, Connecticut
List No.: _
DRAIN LAYER'S PERMIT NO 2982
, 19
Pursuant to written applicattinor, permission i/s herre�byyjgranted to-the Licensed Drain Layer named herein to perform
the work indicated below at � �a1�(�t 1/ ili�.0 on the
side, between
at premises owned byy�� r
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 eipire 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
x
Signed
Connection Charge Paid Licensed Drain Layer
IssuedFby
. x Collect }
+ Permit Fee: Paid $
r INSPECTION: Check Number:
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
INSPECTOR (Sig)