HomeMy WebLinkAboutDrain Layers Permit 139 Rockledge Drive TOWN OF SOUTH WINDSOR
DEPARTMENT OF POLLUTION CONTROL`
South Windsor, Connecticut B/P No.:
/ List No.. _
DRAIN LAYER'S PERMIT0 3391
19�.
br I
Pursuant to written ap licatior, erm' i is hereb granted to the Licensed Drain Layer named herein to perform
/ the work indicated below at �' ' 1 O a .—on the
i
side, etwee
at premises owned by
whose address is
and to Lay House Drain, Repair House Drain, Lay Main, Other
for
occupancy oruse,-
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 reverse side
---- thereof.— Applieant-has-received-Town-Permit N6
and/oi'C H-D�ermilN— -
for --- -
- - --
street excavation.
SPECIAL CONDITIONS
_.,.: -_....y.,....3e:u-a-... ..�._. -..-. ......�.._�i...._.-.ice. .._..._-....-_...___-..............:..._._,.... �. ..... - �.
,l
Signed
4onnection Charge Paid -f Licensed Drain Layer
Issued by
ollector h'
Permit Fee: Paid $
INSPECTION: Check Number: l dO�L
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
INSPECTOR (Sig)