HomeMy WebLinkAboutDrain Layers Permit 95 Skyline Drive (2) Y „ TOWN OF SOUT$ WI N DSOR
DEPARTMENT OF POLLUTION CONTROL
B/P`No.:
South Windsor, Connecticut
1 List.No..
DRAIN LAYER'S PERMITq 624
Pursuant to written applicatior, permission is�hereby gianted to the Licensed Drain Layer named herein to perform
the work indicated below at hA on the
side, between 1111 a31111111M RUSW
at premises owned by—
whose address is
and to _ Lay House Drain, - Repair,House Drain, Lay Main, Other
for occupancy or use,
with oat Family Units, with. acres.
Type of Sewage to be connected under this_Permit:
SANITARY SEWAGE ( ), INDUSTRIAL WASTES .(" ), OR
Connection will be made with CS)"CIL 14VA0
Permit to be issued to
the holder of Drain Layer's License No. Permit will expire on a► 19'r
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
Sig ned�
Connection Charge Paid `" License rain.La er
+lik a vlosts Issued by :I • 9 {411♦f' ift
Tax Collector
Permit..hee:. Paid $
INSPECTION: Check Number:
INITIAL u (Sig)
FINAL (Sig)
APPROVED ,+ (Date)
(Sig)
INSPECTOR