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HomeMy WebLinkAboutDrain Layers Permit 50 Wentworth Drive TOWN OF SOUTH WI N DSOR DEPARTMENT OF POLLUTION CONTROL B/P No.: South Windsor, Connecticut List No.: _ DRAIN LAYER'S PERMIT No 2146 �J�.+v��'V�►uCv � , 19 Pursuant to written appliicappti��or, permission is hereby granted to the Licensed Drain Layer named herein to perform the work indicated below at�� i�—i�, C on the side, between at premises owned by whose address is 16/ 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 alk4he 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 C� Signed Connecti ge,Paid Z�� v Licensed Drain Layer Issued by Tax Collector Permit Fee: Paid $ _L Z INSPECTION: -Check Number: INITIAL (Sig) FINAL (Sig) APPROVED (Date) (Sig) INSPECTOR r. <r _t i I 1 i a . t i I i i SOUTH WMN)c, 0 P0i_1_UTIO'N CONTROL ( O C AT1©N IPIPE ^JOY