HomeMy WebLinkAboutDrain Layers Permit 73 Wood Pond Road I UWN OF SOUTH WINDSOR
DEPARTMENT OF POLLUTION CONTROL
South Windsor, Connecticut B/P No.:
List No.:
DRAIN LAYER'S PERMIT N? 2185
19
Pursuant to written applicatior, permission is hereby rante to the Licensed Drain Layer--named herein to perform
the work indicated below at /�f G `il
on the
side, betweetu
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._02/4 f�7" Permit will expire on 19
The undersigned Drain Layer hereby agrees to a�T�t`h'e 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
Signed.-/� '
;Conjnecti arge Paid ��/� Licensed n Layer
Issued by
Tag Collector
.s Permit Fee:. Paid $
INSPECTION: Check Number:
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
INSPECTOR (Sig)
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