HomeMy WebLinkAboutDrain Layers Permit 197 Palmer Drive TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL
(
B/P No.:South Windsor, Connecticut
List.No.:
DRAIN LAYER'S PERMIT NO 1330
19zz
Pursuant to written applicatior, permiss*on jp hereby gra d to the Licensed Drain Layer named herein to"perform
the work indicate below at 7
-- work,
side, between on the
at premises owned by -e Q
whose address is
and to _4Lay House Drain, Repair House Drain, Lay Main, X Other
for
occupancy or use,
with Family Units, with acres.
Type of Sewage to be connected under this permit:
SANITARY SEWAGE (><INDUSTRIAL W
ii
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
j/
�7_ Signed ,
Connection Charge Paid Licensed Drain Layer
-- /' Issued b
Tax Collector y
Permit Fee:. Paid $
INSPECTION: Check Number:
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
INSPECT (Sig)
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