HomeMy WebLinkAboutDrain Layers Permit South Satellite Road (10) TOWN Of SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL
South Windsor, Connecticut
DRAIN LAYER'S PERMIT XO 55
Pursuant to-written application, permfss.abn*s hereby granted to the Licensed Drain Layer named herein to perform
t e work indicated below at :
on the
side, bet
weeh
at premises owned by _
whose address `!� # - " It�
LANITARY
Lay House Drain, Repair House Drain, Lay Main, Other ,
� A ,�A occupancy or use,
Family Units, with o acres.
tSEW�A:5
to be connected under this permit:
t INDUSTRIAL WASTES, OR
Connection will be made with Y
Petmi"t to be+issued to
the holder of Drain Layer's License No.. Permit will expire on 4f 19
The undersigned Drain Layer hereby agrees to all"the terms and conditions set forth on the permit and`the reverse side
t
? thereof. Applicant has received Town Permit No. and/or.0 H D:Permit No.
_..• ^ - xf
for street excavation.
w SPECIAL CONDITIONS
Wow
i,.. 7",1W
jai
OzA
-jr 4W-
Signedr /" ,
Connectioin-Cha*-I' aid $At icensed Drain Layer
' rf
(Sig) Issued by.
Tag Collector
Permit Fee: Paid $ 4�,'
INSPECTION:
INITIAL (Sig)
FINAL (Sig)
APPROVED_ Mr (Date)
l _ * (Sig)
l
I SSPPECTOR