HomeMy WebLinkAboutDrain Layers Permit 1203 Summer Hill Dri TOWN OF SOUTH WINDSOR
DEPARTMENT OF POLLUTION CONTROL
South Windsor, Connecticut B/P No.:
List No.. _
DRAIN LAYER'S PERMIT N'O
• 2885
Pursuant to written applicator, p rmission is hereby gr d to the Licensed Drain Layer named herein to erfor
the work indicated below at �a��� P m
side, be714,
en on the
at premises owned by
whose address is
and to Lay House Drain, Repair House Drain,
for Lay Main, Other
with occupancy or use,
Family Units, with
Type of Sewage to be connected under this permit: acres,
SANITARY SEWAGE ( ),, INDUSTRIAL WASTES .( ) OR
Connection will be made with ( )
Permit to be issued to
the holder of Drain Layer's License No. Permit The undersigned Drain Layer hereby agrees to all the terms and cond'tions set lfor expire
the permit and the reverse 19
thereof. Applicant has received Town Permit No. se side
for street excavation. and/or C H D Permit No.
SPECIAL CONDITIONS
Connection Charge Paid c Signeu
g DU �O Licensed Drain Layer
Tax Collector Issued by
Permit Nee: Paid $
INSPECTION: Check Number:
INITIAL
(Sig)
Sig)
APPROVED (Sig)
(Date)
INSPECTOR (Sig)