HomeMy WebLinkAboutDrain Layers Permit 183 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? 3 04
19_L
Pursuant to written applicator, permission is hereby granted to the Licensed Drain Layer named herein to perform
Q� w the work indicated below at /D I 0 s 008 Pond on the
a
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.
r.:r
t
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
f�, �,.. Signed
Conne�' arge Paid `7 r �� Licensed Drain Layer
Issued by
Tax Collector 12,_..7�
Permit Fee: Paid $
INSPECTION: Check Number: �Z-_
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
(Sig)
INSPECTOR