HomeMy WebLinkAboutDrain Layers Permit 15 Wood Pond Road I vW14 OF SOUTH WINDS09
DEPARTMENT OF POLLUTION CONTROL
South Windsor, Connecticut B/P No.:
List No.:
DRAIN LAYER'S PERMIT
N° 2685
Pursuant to written applicator
permission is he gr red to a Licensed Drain Layer named herein to perform
the work indicated below at `/l/� ,�-
side, betwee on the
at premises owned by
whose address is
----------------
and to Lay House Drain,
Repair House Drain,
for Lay Main, Other
with occupancy or use,
Family Units, with
Type of Sewage to be connected under this permit: acres.
SANITARY SEWAGE ( ), INDUSTRIAL WASTES
Connection will be made with ( )� OR
Permit to be issued to
the holder of Drain Layer's License No.
The undersigned Drain Layer hereby agrees to all Permit will expire on 19
the terms and conditions set forth on the permit and the
thereof. Applicant has received Town PermitNo, reverse side
for street excavation. and/or C H D Permit No.
SPECIAL CONDITIONS
Connection Ch7 Signed
aid tI /� 7/L
Licensed Drain Layer
ax Collector Issued by
Permit Fee Paid $
INSPECTION: Check Number:
INITIAL
FINAL (Sig)
APPROVED (Sig)
(Date)
INSPECTOR (Sig)