HomeMy WebLinkAboutDrain Layers Permit n/s Strong Road TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL
South Windsor, Connecticut B/P No.:
1 List No.: _ -SR 1 I �7
DRAIN LAYER'S PERMIT IN? �237
i
, 19
I
j Pursuant to written appliELulki
e ' ion is hereby gr ted to the Licensed Drain Layer named herein to perform
the work indicated below at ��
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.
- ECIAL—CONDITIOIVS"-^
Signed
CoZ* rge Paid Olt Y // Licensed Drain Layer
Issued by
- Tax Collector
Permit Fee:. Paid $ /�IA
INSPECTION: Check Number:
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
(Sig)
INSPECTOR