HomeMy WebLinkAboutDrain Layers Permit 251 Skyline Drive TOWN OF, SOUTH Wt N DSOR
DEPARTMENT OF PO: LUTION t`CONTROL '
B/P No.
South Windsor, Connecticut ,
3
�< List No.: _
DRAIN LAYER'S =PERMIT p fi38
Pursuant to.i itten a licatior, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at J. `
on the
side, between
at premises-owned by
whose address is-
rand 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 WASTE$ .( ); OR
Connection,will be made with
gam,
Permit to be issued to s
the holder of Drain Layer's License No. Permit will expire on_
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.. _
h SPECIAL CONDITIONS
t .
.Signed j r�
Connection Charge Paid Licensed'Drain Layer
Issued by
i
Tax Collector`. ;
Permit Fee: Paid $
INSPECTION• Check Number:,
INITIAL (Sig)'
FINAL
. _ . . (Sig)
APPROVED f � .(Date) 1
(Sig)
INSPECTOR