HomeMy WebLinkAboutDrain Layers Permit 1201 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 NO 2864
19
Pursuant to written appiicatior, p rinission is hereby granted ttR the Licensed Drain Layer named herein to perform
the work indicated below at o ywy on the
side, betwe7n4i
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 ( ), 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 an, 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 °�Q�.�(� Licensed Drain Layer
Issued by
J` Tax Collector
Permit Fee: Paid $
INSPECTION: Check Number: J
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
(Sig)
INSPECTOR