HomeMy WebLinkAboutDrain Layers Permit 46 Rockledge Drive TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL gip No.:
South Windsor, Connecticut
List No.: _
DRAIN LAYER'S PERMIT N0 3055
, 19 ��
Pursuant to written applicatior, permima.
' seb granted to the Licensed Drain Layer named herein to perform
the work indicated below at -/ C on the
side, between
at premises-owned byL& C - L A dLCtn
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 { 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.- Ap lica_ ha s_received_Town Permit No, and/or C.,H,D. Permit-No.
for street excavation.
SPECIAL CONDITIONS
C1.3 U Signed
C nnection Charge Paid Q U.00 f 1- f 3 Licensed Drain Layer
` ' U Issued by
T Collecto
Permit Fee: Paid $ ��r o d_
INSPECTION: Check Number:
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
(Sig)
INSPECTOR