HomeMy WebLinkAboutDrain Layers Permit 81 Rockledge Drive TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL Bhp No.:
South Windsor, Connecticut
List No.: _
DRAIN LAYER'S PERMITS 3564
19
Pursuant to written applTo
tior permission iAireby rant d to the Licensed Drain Layer named herein to perform
�,y
the work indicated below at � f l � V� N W �lii S on the
• side, be� een
at premises owned by
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: ti
SANITARY SEWAGE ( j, 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-_suEet::e=avation
SPECIAL CONDITIONS
/ Signed
C nection Charge Paid _ Licensed Drain Layer
Issued by
Ta
X Permit Fee: Paid $ /6 U
INSPECTION: Check Number: L6 3 59
INITIAL (Sig)
FINAL n (Sig)
APPROVED /� �Z��(��J (Date)
(Sig)
INSPECTOR