HomeMy WebLinkAboutDrain Layers Permit 166 Wood Pond Road TOWN OF SOUTH Wl N DSOR
, DEPARTMENT OF POLLUTION CONTROL B/P No.:
South Windsor, Connecticut
List No.: _
DRAIN LAYER'S PERMIT N? 3029
19—
Pursuant to written applicatior, permission is hereby
granted to the Licensed Drain Layer named herein to perform
the work indicated below at e �� ] �A J 0100( R01L t on the
side, bet e n
at premises owned by Ct
whose address is 7 AWP
and to - Lay House Drain, Repair House Drain, Lay Mai.
for ,,cupancy or use,
with Family Units, with
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. 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 Charge Paid -, ) ,v ' Licensed Drain Layer
Issued by
Tax Collector
�� Permit Fee: Paid $ :
INSPECTION: Check Number:
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
(Sig)
INSPECTOR