HomeMy WebLinkAboutDrain Layers Permit 32 Rainbow Trail (2) TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL
B/P No.:
South Windsor, Connecticut J�D
List.No.: _
��- DRAIN LAYER' S PERMIT NO 1365
19
WL
Pursuant to written applica ior, permosion is hereby granted to the Licensed Drain Layer named herein to perform
the work indfcataed below at �� e �F'
' - � �f `� / � on the
G ` side, between A—r)
at premises owned by i
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
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 V
Connection Charge Paid ��� Licensed Drain 1�yec-.r
Tax Collector Issued by
Permit Fee: Paid $ _--LL�I
INSPECTION: Check Number:
INITIAL (Sig)
FINAL (Sig)
APPROVED •µ (Date)
(Sig)
INSPECTOR
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NOTES SOUTH WINDSOR POLLUTION CONTROL
LOCATION
OWNER
TYPE OF WORK
DATER- PERMIT PIPE
INSTALLER
INSPECTOR DRAWN BY /