HomeMy WebLinkAboutDrain Layers Permit 807 Summer Hill Driv TOWN OF SOUTH WINDSOR
DEPARTMENT OF POLLUTION CONTROL B/P No.:
South Windsor, Connecticut
List No.:
DRAIN LAYER'S PERMIT 3035
19_�
Pursuant to written ap licatior, permis 'on is her y gra ted to the Licensed Drain Layer named herein to perform
the work indicated below a ,
on the
side, bgtween
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 ( 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
6 q ! ` / Signed
connection Charge PaidL .0(�. (� (� �L/��3 Licensed Drain Layer
Issued by
�,T Collector j
Permit Fee:. Paid $
INSPECTION: Check Number:
_ INITIAL (Sig)
FINAL (Sig) -
APPROVED (Date)
(Sig)
INSPECTOR