HomeMy WebLinkAboutDrain Layers Permit 70 Roinda Drive • •• .. • . v. avv � �7 n �IVVJVR
DEPARTMENT OF POLLUTION CONTROL
South Windsor, Connecticut B/P No.:
List No.: %C)
DRAIN LAYER'S PERMIT N? 2077
C , 19 lV
Pursuant to written applicatior, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at nor, V
on the
side, between
at premises owned by_ /!C�/,�
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 ( INDUSTRIA%L 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 Aand the reverse side
thereof. Applicant has received Town Permit No. and/or C H D Permit No.
for street excavation.
SPECIAL CONDITIONS
D p 0
Connection Charge Paid Signed
Yu ? Licensed Drain Layer
-
Tax Collector Issued by
d o� '2 �
ermit Fee: Paid
INSPECTION: Check Number:INITIAL (Sig ��e,, /v C C l>
FINAL (Sig)
APPROVED — C1 (Date)
(Sig)
INSPECTOR
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