HomeMy WebLinkAboutDrain Layers Permit 26 Wood Pond Road TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL B/P No.:
South Windsor, Connecticut
n List No.: _
DRAIN LAYER'S PERMIT N? 2566
,t Q , 19 0
Pursuant to written appl' atior perm ssion is hereby granted
to t Licensed Drain Layer named herein to perform
the work indicated below at 51 cz .�A)/I7y on the
side, be ween
at premises owned by o
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
Signed
nnection Charge Paid �� Licens rai ayer
f, 7&L-p
Issued by
T � Collecfer
4Permit Fee: Paid $ _
INSPECTION:
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
(Sig)
INSPECTOR