HomeMy WebLinkAboutDrain Layers Permit 16 Ronda Drive I VWN Of SOUTH WINDSOR
e DEPARTMENT OF POLLUTION COVTROL B/P No.:
South Windsor, Connecticut
• List No.: _
DRAIN LAYER'S PERMIT Np 2418
19 �
Pursuant to written app/lic�ior, 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 J
i- 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 reverse side
thereof. Applicant has received Town Permit No. and/or C H D Permit No.
for street excavation.
SPECIAL CONDITIONS -
J '1 Signea
Connection Charge Paid l�d. U Licensed Drain Layer
Issued by
/_)Tax Collector
Permit Fee Paid $ _ -
INSPECTION: Check Number:
i
INITIALuu
(Sig)
FINAL (Sig)
APPROVED (Date)
(Sig)
INSPECTOR
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