HomeMy WebLinkAboutDrain Layers Permit 90 Wentworth Drive l umn yr avu 1 rl WINDSOR
DEPARTMENT OF POLLUTION CONTROL
South Windsor, Connecticut BAP No.:List No.: _ 3.1-0 q
DRAIN LAYER'S PERMIT Np 2210
Pursuant to written �U 'o LJ��"�(S� f
applicatior, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at
�j
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 I
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. }
for street excavation. and/or C H D Permit No.
SPECIAL CONDITIONS
Signed
Connection Charge Paid Yl �O D
'� Licensed Drain Layer
Issued by
Permit Nee: Paid $
INSPECTION: Check Number�-
INITIAL (Sig) 7"
FINAL (Sig)
APPROVED (Date)
INSPECTOR (Sig)