HomeMy WebLinkAboutDrain Layers Permit 17 Paper Chase TOWN OF SOUTH WI N DSOR
DEPARTMENT
OF POLLUTION CONTROL - gip No.:
South Windsor, Connecticut
List.No.: _
DRAIN LAYER'S PERMIT O 3566
19 s
1 ri
Pursuant to written applicati r, permission is herW granted to th Licensed Drain Layer named herein to perform
the work indicated below at (// on the
side, betwe'en
at premises owned by—
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 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
Signed
Connection arge Paid 11264 License 01 ain Laye
Issued by l.4
ax Collector
Permit Fee: Paid $
INSPECTION: Check Number: �3-- -f—
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
(Sig)
INSPECTOR