HomeMy WebLinkAboutDrain Layers Permit 121 Stonefield Trail • ` .f. -fir. � - `' k
TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL B/P No.:
South-Windsor, Connecticut
List No.: _
DRAIN LAYER"S PERMIT XO �567
19 .
Pursuant to written applicatior, permission i hereby granted to the Licensed Drain Layer named herein to perform
the work indicated bel'gw at r ( 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
Conne n'Charge Paid !� Lice e Drain Layer
Alr,
Issued by
Tax Collector _ 1
Permit Fee:. Paid ��_�_✓
INSPECTION: Check Number: > i
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
(Sig)
INSPECTOR