HomeMy WebLinkAboutDrain Layers Permit 59 Pine Tree Lane TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL gip No.:
South Windsor, Connecticut
List No.: _
DRAIN LAYER'S PERMIT O 3561
19 �
Pursuant to written applicatior, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at U5311� on the
side, between
G
at premises ownedwhose address 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
�y,p,. a
Signed
Connection Charge Paid /�/Q j) 0 d Licensed Drain Layer
2L.'Le • ;h\ Issued by
awn, Tax Collector
J Permit Fee: Paid $ ---
INSPECTION: Check Number: vgo,aZ,
INITIAL 2-�2y�' - , (Sig
.
Y��
FINAL (Sig)
APPROVED (Date)
(Sig)
INSPECTOR