HomeMy WebLinkAboutDrain Layers Permit 1304 Summer Hill Dri TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL
South Windsor, Connecticut B/P No.:
List No.: _
DRAIN LAYER'S PERMIT NO 2838
� 19_
Pursuant to written applicatior, permission is heby granted to the Licensed Drain yer named he e5[n o perform
the work indicated below at
t e
side, between
at premises owned by
whose address is
and to Lay House Drain, Repair House Drain, Lay-Main, Other
1
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
95 Signed
onnection Charge Paid. /1, 3 Licensed Drain Layer
Issued by
(Y �/ • a Permit 'pee: Paid $ _ U
INSPECTION: Check Number:
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
z�.
(Sig)
INSPECTOR