HomeMy WebLinkAboutDrain Layers Permit 37 Robert Drive (3) w
TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL
B/P No.:
South Windsor, Connecticut
List No.: y yv
DRAIN LAYER' S PERMIT N9 Sol
19
Pursuant to written applicatior, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at on the
side, between
at premises owned by A
whose address is
and to Lay House Drain, Repair House Drain, Lay Main, Other
for occupancy or use,
with 0 Family Units, with acres.
Type of Sewage to be connected under this permit:
SANITARY SEWAGE ( ), INDUSTRIAL WASTES ( ), OR ( )
Connection will be made with ry i.es• h j►#pj&p,'12E+
Permit to be issued to Ta#7,✓ �:�„ F,:
the holder of Drain Layer's License No. 4/`4 ..:a'0 61$f Permit will expire on 19
The undersigned Drain Layer hereby agrees to all the t rms 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 l Licensed D-an Layer,'
Issued i"r p Issued by
Tax Collector
Permit Fee: Paid $
INSPECTION:- Check Number:
INITIAL 'i (Sig)
FINAL ' (Sig)
APPROVED f F (Date)
(Sig)
INSPECTOR