HomeMy WebLinkAboutDrain Layers Permit 4 Rosemary Lane TOWN OF SOUTH WINDSOR
DEPARTMENT OF POLLUTION CONTROL
B/P No.:
South Windsor, Connecticut
List.No.: �6 y
DRAIN LAYER"S PERMIT NO 1637
19 _
Pursuant to written applicatior, permission is hereby ranted to the Licensed D in Layer named herein to perform
the work indicated below at —
on the
side, between G
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:
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 � 3 19
The undersigned Drain Layer hereby agrees to all the terms and conditions set forth on the permit and the reverse sidde
thereof. Applicant has received Town Permit No. and/or C H D Permit No.
for street excavation.
SPECIAL CONDITIONS
Signed
Connection Charge Paid s/ -7 Licensed Drain Layer
Issued by
Tax Collector ����--
Permit Fee:. Paid $ _� c_frl
INSPECTION: Check Number: T
INITIAL (Sig)
FINAL (Sig)
APPROVED ate)
(Sig)
INSPECTOR