HomeMy WebLinkAboutDrain Layers Permit 106 Wentworth Drive TOWN OF SOUTH WINDSOR r .
DEPARTMENT OF POLLUTION CONTROL
South Windsor, Connecticut B/P No.:
List No.: _
DRAIN LAYER'S PERMIT Np 2324
ClX ,
Pursuant to written appli�at/ior, permi
f 1 ssion is hereby grante to the Licensed Drain Layer named herein to perform
the work indicated below at //t� #I t) —
? � t
side, between on the
at premises owned
whose address is
and to Lay House Drain, Repair House Drain,
Lay-Main, Other
for
with occupancy or use,
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 The undersigned Drain Layer hereby agrees to all the terms and conditions s tlforth on the permit and the reverse s9 expire on
de
thereof. Applicant has received Town Permit No.
for street excavation, and/or C H D Permit No.
SPECIAL CONDITIONS
1 Signed
\1 Connection Char e Paid O.6 p
Licensed Drain Layer
A" Issued by
Tax 11Collector f Permit Fee: Paid $
INSPECTION: Check Number:
INITIAL �"K)9 Q.�` +��e.�—
(Sig)
FINAL
(Sig)
APPROVED
(Date)
INSPECTOR (Sig)