HomeMy WebLinkAboutDrain Layers Permit 29 Wood Pond Road TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL
B/P No.:
South Windsor, Connecticut
List No.: _
DRAIN LAYER'S PERMIT N.O
2686
19 S 2-
Pursuant to written applica/t}'orper ion is hereby granted tot icenqf9i Drain Layer named herein to perform
the work indicated below at Gam' T �GC^, '�
on the
side, betwee
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 19
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
r' r
Signed
Connection rge Paid 147/ // Licensed Drain Layer
Issued by
Tax Collector
�� �L '
Permit Fee:. Paid Z_
�-�-'�
INSPECTION: Check Number:
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
_-- - INSPECTOR (Sig)