HomeMy WebLinkAboutDrain Layers Permit 556 Rye Street TOWN OF SOUTH WINDSOR
DEPARTMENT OF POLLUTION CONTROL
South Windsor, Connecticut B/P No.:
List No.: _
DRAIN LAYER'S PERMIT N0 2267
19
Pursuant to written applicani/or, ermission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at Lr
on the
si e, 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
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 and the reverse side-
thereof. Applicant has received Town Permit No. and/or C H D Permit No.
for street excavation.
�` --- — SPECIAL CONDITIONS
1 Signed
Connection Charge Paid Licensed Drain Layer
TG � l/ Ti Issued by
Tax Collector
r
�� -
Permit Fee:. Paid $
INSPECTION: Check Number
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
(Sig)
INSPECTOR .