HomeMy WebLinkAboutDrain Layers Permit 84 Wentworth Drive TOWN OF SOUTH WINDSOR
DEPARTMENT OF POLLUTION CONTROL
South Windsor, Connecticut B/P No.:
List No.: _
DRAIN LAYER'S PERMIT 'N? 2905
19 "
Pursuant to written a li atior V
p , permission is hereby granted yp the Licensed Dr in Layer named herein to perform
the work indicated below at � P.
�' ] fi--_. },�j�`I .-}"{''fib/
' on the
side, between
at premises owned by
whose address is
and to Lay House Drain, Repair House Drain, LaMain,
y 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
i
Permit to be issued to
the holder of Drain Layer's License No. Permit will expire on l
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.
SPECIAL CONDITIONS
ction Charge Paid 4A)Lj Signed
-� • _..� Licensed Drain Layer
A {/`~` a Issued by
,ollector
Permit Fee Paid $
INSPECTION: Check Number:
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
INSPECTOR (Sig)