HomeMy WebLinkAboutDrain Layers Permit Club House - Parkvie TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL B/P No.:
South Windsor, Connecticut
List No.: _
DRAIN LAYER'S PERMIT N? 2451
19 07
Pursuant to written appli tior, permi sion is hereby ranted to the Licensed Drain Layer named herein to perform
the work indicated below at ,ir !As on the
side, between
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
s
Signed
Connection Charge Paid Licensed Drain Layer
LLB— Issued by
Tax Collector
Permit Nee: Paid $ ,
INSPECTION: Check Number:
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
(Sig)
INSPECTOR