HomeMy WebLinkAboutDrain Layers Permit 128 Rosemary Lane TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL BAP No.:
South Windsor, Connecticut
List.No.:
DRAIN LAYER'S PERMIT NO 1635
/I11a4j� 2- - , 1q 79
Pursuant to written applicattiior, permission is
hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at C. / 0 cLaLaf
the
AfYA—side, between
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.. ..,2�
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 side F
thereof. Applicant has received Town Permit No. and/or C H D Permit No.
for street excavation.
SPECIAL CONDITIONS
Signed
Connection Charge Paid - Lic nse Drain Layer
C ' Issued by �
Tax Collector
Permit Fee: Paid $
INSPECTION: Check Number: , 1 9 7
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
(Sig)
IN EC OR