HomeMy WebLinkAboutDrain Layers Permit 500 Pleasant Valley (2) TOWN OF SOUTH WINDSOR
DEPARTMENT OF POLLUTION CONTROL
South Windsor, Connecticut
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DRAINLAYER'S PERMIT
O 13
19
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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
1090 side, between `
at premises owned by
whose address is V SUN& ft$ * -
and to X Lay House Drain, Repair House Drain, Lay Main, Other
for occupancy or use,
with QW 0) Family Units, with acres.
Type of Sewage to be connected under this permit:
SANITARY SEWAGE, INDUSTRIAL WASTES, OR
Connection will be made with am"06 (60)
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
Signed
Connection Charge Paid ,$ Licensed Drain Layer
(Sig) Issued by OW:No
Tax Collector
Permit Fee:�Pa '�
INSPECTION:
INITIAL (Sig)
FINAL. (Sig)
APPROVED XeDtMber. 1 (Date)
• (Sig)
INSPECTOR