HomeMy WebLinkAboutDrain Layers Permit 585 Rye Street i
TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL B/P No.:
South Windsor, Connecticut
List No.: _
DRAIN LAYER'S PERMIT NO 2545
Pursuant to written applicatior, permissiop is hereby granted to the LicenW Drain Layer named herein to perform
the work indicated below at on the
side, betweIn
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 ( 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 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 `/9
Signed
Connection Charge Paid //0-) U'd Licensed Drain Layer
Issued by
Tax Collector
Permit Fee: Paid $ _
INSPECTION: Check Number:
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
(Sig)
INSPECTOR