HomeMy WebLinkAboutDrain Layers Permit Lot 1, Rye Street TOWN OF SOUTH WINDSOR
i U DEPARTMENT OF POLLUTION CONTROL
`( South Windsor, Connecticut B/P No.:
OY� List No.:
b BRAIN LAYER'S PERMIT .N? 2895
Z 19 3
Pursuant to written applica -or, ermiss on is hereb granted to the Licensed Drain Layer named herein to
the work indicated below at perform
side, between on the
at premises owned by
whose address is
and to Lay House Drain, Repair House Drain,
Lay Main, Other
for
with occupancy or use,
Family Units, with
Type of Sewage to be connected under this permit: acres.
SANITARY SEWAGE ( ), INDUSTRIAL WASTES .( ), OR ( )
Connection will be made with
Permit to be issued to
the holder of Drain Layer's License No.
Permit wThe undersigned Drain Layer hereby agrees to all the terms and conditions s tlfor expire
he permit and the reverse side thereof. Applicant has received Town Permit No.
for street excavation. and/or C H D Permit No.
SPECIAL CONDITIONS
CXTax
. Charge Paid (�+ 6 Signea
Licensed Drain Layer
lector Issued by
Permit Fee: Paid ` 1
INSPECTION: Check Number: . /6 ,1
INITIAL
(Sig)
Sig)
APPROVED (Sig)
(Date)
\ INSPECTOR (Sig)
1