HomeMy WebLinkAboutDrain Layers Permit 36 Benjamin Way (2) TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL B/P No.: _
South Windsor, Connecticut
6 List.No.: _
DRAIN LAYER'S PERMIT O 3201
, 19
Pursuant to written app icatior, permission is hereby ranted to the Licensed Drain Layer named herein to perform
the work indicated below at on the
side, between
at premises owned by wl� r~ S
whose address is
and to Lay House Drain, Repair House Drain, Lay Main, Other
for occupancy or use,
with Family Units, withl 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
Signed
nnection Charge Paid 0 Q Licensed Drain Layer
F Issued by
• T CellectqV
Permit Fee:. Paid $
INSPECTION: Check Number: ��
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
(Sig)
INSPECTOR