HomeMy WebLinkAboutDrain Layers Permit 74 Scantic Meadow Ro TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL
B/P No.:
South Windsor, Connecticut
List No.: _
DRAIN LAYER'S PERMIT N? 2341
, 19
Pursuant to written applica/ti`or, pe mission is hereby ranted to the Licensed Drain Layer named herein to perform
the work indicated below at �7 on the
side, 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
Signed
;Con:nectio arge Paid ice r n ayer
Issued by
Tax Collector
Permit Fee: Paid $
INSPECTION: Check Number:
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
(Sig)
INSPECTOR
i
N
PtOTES SOUTH WZNDSOR POLLUTION COf'l7rROL
LOCATION '
"e
OW NE
TYPE OF t7ORK r / F+
DATE _ i PERMIT PIE " .
INSTALLER F
INSPECTOR 17 DRAWN BY