HomeMy WebLinkAboutDrain Layers Permit 51 Riverside Drive _ TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL
- B/P No.:
South Windsor, Connecticut
List No.: _
DRAIN LAYER'S PERMITO 3293
9a' '(4�`L 119
Pursuant to written ap licatior, perrmis ion is hereby granted to the Licensed Drain/ Lea er named herein to perform
the work indicated below at C7 0 �V/(� ti��� s �I V�( 0Jd—C� on the
side, between
at premises owned by
6 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 _( ), 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 ieverse side
_ ,.
thereof. Applicant has received Town Permit No. and/or C H D Permit No.
... ..
forstrcec-e�aat+�t-ion;--.____
SPECIAL CONDITIONS
Signed
Connection Charge Paid#00,0 0 Licensed Drain Layer
W ,
- Issued by
x Cgrto f
u-/ J Permit Fee: Paid $ _-ZLO U
INSPECTION: Check Number: 0 1� I �( a
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
' (Sig)
INSPECTOR