HomeMy WebLinkAboutDrain Layers Permit 306 Strong Road (2) 'n" TOWN OF'S0UTH WINDS OR
DEPARTMENT OF POLLUTION CONTROL
- �.•..J South Windsor, Connecticut
sta DRAIN LAYER'S PERMITp ss
if ar, , 19 _
Pursuant to written application, permission is hereby granted to the Licensed Drain Layer named her to perform
the work indicated below at
on the
side, between `it
at premises owned by
whose address is ;itL �,,,..
and to _Lay House Drain, Repair House Drain, Lay Main, Other
for-111Lr12 .ula�
occupancy or use,
with_0AW Z Family Units, with ADDA . _pAj acres.
Type of Sewage to be connected under this permit:
NITARY E� INDUSTRIAL WASTES, OR
w�r..rr
Connection will be made with rtv AV�
Permit;to be issued to # #"1
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 an "the reverse side
thereof. Applicant has received Town Permit No. and/or C H D Permit No.
for street excavation.
SPECIAL CONDITIONS
Signed
Connection Charge Paid $ Licensed rain Layer
(Sig) Issued by ,.
Tax Collector
Permit Fee: Paid $` �
INSPECTION:
INITIAL ------� (Sig)
FINAL y .,.
-�'--�---�. (Sig).
3
APPROVED ... (Date)
(Sig)
INSPEC OR