HomeMy WebLinkAboutDrain Layers Permit 95 Scantic Meadow Ro • v•• um yr 3vu i rl WINDSOR
DEPARTMENT OF POLLUTION CONTROL
South Windsor, Connecticut B/P No.:
List No.: _
DRAIN LAYER'S PERMIT No 2345
19
Pursuant to written applicaat}ior, permission is hereby granted to the LicensedDrain Layer named herein to perform
the work indicated below at
on the
side, between
at premises owned
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 I
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.
for street excavation. and/or C H D Permit No.
SPECIAL CONDITIONS
,.t Sighed
Connection Char Paid 6 Licensed Drain Layer
Issued by
Tax Collector
d7/
Permit Fee Paid !
INSPECTION: Check Number:
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
INSPECTOR (Sig)
MI
49
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