HomeMy WebLinkAboutDrain Layers Permit Lot 1 nINLJ3VK
( DEPARTMENT OF POLLUTION CONTROL
( South Windsor, Connecticut B/P No.:
List No.: _
DRAIN LAYER'S PERMIT
p 2947
199
Pursuant to written applicattior, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at_ ,C
on the
side, betwfiee
at premises owned by //r
whose address is
and to Lay House Drain, Repair House Drain, LaMain,
y Other.
for
occupancy or use,
with Family Units, with
acres.
Type of Sewage to be connected under this permit:
SANITARY SEWAGE ( j, 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 1 A
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. A
for street excavation.
SPECIAL CONDITIONS f;
z
t
-
Connectio Signed rge Paid 117i
3 Licensed Drain Layer
Issued by
Tax Collector
Permit Fee: Paid $Z>
INSPECTION: Check Number: Y 7
INITIAL (Sig)
FINAL (Sig)
APPROVED
(Date) ;?
k
(Sig)
INSPECTOR i r