HomeMy WebLinkAboutDrain Layers Permit 1105 Summer Hill Dri TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL
B/P No.:
South Windsor,Connecticut
List No.:,_
DRAIN LAYER'S PERMIT N? 2934
C
; 19�•�
Pursuant to written applicatior, pe mission is here/by grantedjp the Licensed Drain Layer named herein to perform
the work indicated below at �Z(1:5 . I W/rH O- /l'�{.(,/ on the
side,:bet een
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 { j, 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
Signed
Connection Charge Paid "106 -Q D Licensed Drain Layer
AA 1 �e 1 �l f nA- Issued by
Tax Collector
Permit Fee: Paid $ _/ d
INSPECTION: Check Number:
--- - - INITIAL
(Sig) _
FINAL (Sig)
APPROVED (Date)
(Sig)
INSPECTOR