HomeMy WebLinkAboutDrain Layers Permit 107 Pine Knob Drive (2) 7-0 N fl� SOUT VYIN JSOR ,f
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tf PARTM9NT: POLLUTION CONTROL
B/P No.. -�
South Windsor, Conneet�eut:
List.No.:
DRAIN LA;YE.R'S ,PERMiT ;
---- ITT° 6
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Pursuant to written appli.•cauor,.permission is hereby granted"to the:Licensed
'Drain Laker named herein to perform
r the work indicated below.at ,
on the.
side, between
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at premises owned by
whose address is
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and to Lay House Drain, Repair House Drain,. Lay Main, Other
y Accopancy or'use,
r with Family Units,..with. s:
e
` :' Tge.of.Sewage to be connected under this permit:
SANITARY SE*AGB'
( , INDUSTRIAL WASTES
Connection will be,made with
.f
Per 'to`be issued'to
the holder of Drain Layer's Liceri"se•No. Permit will expire on 19
The undersigned Drain Layer herebx agrees to all the to;ms anti conditions set foith bn 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 "
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Signed •+�w' �
Connection Charge Paid Licensed Drain Layer
y Issued by ! b
Tag Collector
Permit 1~ee Paid $ _ .
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IIVSP;ECTION: Checlt Number:
-- INITIAL.
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FINAL (Sig)
APPROVED_ f- f (bate)
INS
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