HomeMy WebLinkAboutDrain Layers Permit 806 Summer Hill Driv TOWN OF SOUTH WINDSOR
DEPARTMENT OF POLLUTION CONTROL
B/P No.:
South Windsor, Connecticut
List.No.: _
DRAIN LAYER'S PERMIT NO 3099
19
Pursuant to written applicatior, pe 'mission is hereby granted to the Licensed Drain Layer named herein to perform
"5 the work indicated below at__ ��� IJVlf9r fL on the
side, betwe
at premises owned
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
Signed
Connection Charge Paid Licensed Drain Layer
6
� w Issued by
Tax Coilector �)
Permit Fee: Paid $
INSPECTION: Check Number:
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
INSPECTOR (Sig)