HomeMy WebLinkAboutDrain Layers Permit 165 Scantic Meadow D TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL B/P No.:
South Windsor, Connecticut
List No.: _
DRAIN LAYER'S PERMIT NO 3`^00
Pursuant to written appli/catior, per 1 sion is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at on the
side, bet aen
at premises owned by
whose address is
and to Lay House Drain, Repair House Drain, Lay Main, Other ,
for occupancy or use,
with Family Udits, 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 jayer hereby, agree4 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.
-'fd&Areet`exca avian:
SPECIAL CONDITIONS
/ G Signed
Connec arge Paid 0 � Licensed Drain Layer
Issued by /
Tax-Collector
Permit Fee: Paid $
INSPECTION: Check Number:
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
(Sig)
INSPECTOR