HomeMy WebLinkAboutDrain Layers Permit 102 Pleasant Valley i# • TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL
+� South Windsor, Connecticut
SAO
DRAIN LAYER'S PERMIT O 146
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Pursuant to written application, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at on the
NOW
r side, between—
at premises owned ve vivo a
whose address is_ rs
and to _' Lay House Drain, Repair House Drain, . Lay Main, Other
for occupancy or use,
with Oft Family Units, with acres.
Type of Sewage to be connected under this permit:
SANITARY SEWAGE, X INDUSTRIAL WASTES, OR
w Connection will be made withabboa M��
06
Permit to be issued to M�
the holder of Drain Layer's License No. Permit will expire on 19
The undersigned Drain Layer hereby agrees to all t e terms and conditions set forth on the�m-TrIMM a riPh everse s
thereof. Applicant has received Town Permit No. and/or C H D Permit No.
for street excavation:
SPECIAL CONDITIONS
Signed
Connection Charge Pai= 114o"6ft Licensed Drain Layer
(Sig) Issued by N114" 11hog"t Air,
Tax Collector
Permit Fee: Paid $ „
INSPECTION:
INITIAL (Sig)
FINAL (Sig)
APPROVED %W4K%W4 ' (Date)
P CTOR (Sig)