HomeMy WebLinkAboutDrain Layers Permit 1503 Summer Hill Dri TOWN OF SOUTH WINDSOR
DEPARTMENT OF POLLUTION CONTROL
South Windsor, Connecticut B/P No.:
List No.: _
DRAIN LAYER'S PERMIT N° 2658
G Z
Pursuant to written applieati r, permis is hereby granted t the Licensed Drain Layer na ed herein to perform
the work indicated below at,
on the
AA
side, betwee
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 ( 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
f
Connect arge Paid (/� /B L 2r Signed Licensed Drain Layer
Issued by
Tax Collector
Permit Fee: Paid
INSPECTION: Check Number:
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
- (Sig)
INSPECTOR