HomeMy WebLinkAboutDrain Layers Permit 80 Wood Pond Road TOWN OF SOUTH WINDSOR
DEPARTMENT OF POLLUTION CONTROLr
South Windsor, Connecticut J � '
List No.: _ 0 01`
DRAIN LAYER'S PERMIT Np 2184
119
Pursuant to written applicatior, permission is hereby gra d to the Licensed Drain Layer named herein to perform
the work indicated below at
on the
side, between
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 ( j, INDUSTRIAL WASTES .( ), OR ( )
Connection will be made with
Permit to be issued to
the holder of Drain Layer's License No. v70 6 9,1 --7> 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
Signed..- -`"_"__
Connection a Paid License rain Layer
7 lax Collector Issued by
Permit Fee:. Paid $
INSPECTION: Check Number: �- ll
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
(Sig)
INSPECTOR
1 _
s
s
t
s
r
a
V
i
g i
a
F
S
LAJ
S,
NTH y f
s � tFJ IN�JSVf� t�S..l'_I..UfiI�. N CK�(vT RGl_
L d�
r
INS aE TO S. C pPAW
-- --
N t3 Y