HomeMy WebLinkAboutdrain layer permit 352 / 1.O TH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL
South Windsor, Connecticut B/P No.:
List No.: _
DRAIN LAYER'S PERMIT Np 2562
r�
' 19
Pursuant to written app�liicatior, permi l ion is hereby granted t the Licensed Drain Layer named herein to perform
the work indicated below at x j }
on the
side, between
at premises owned
whose address is
and to Lay House Drain, Repair House Drain, La 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 1
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
1 ned
Connection Charge Paid �` . �;L� �p;���� Si g Licensed Drain Layer
Tax-CO TC�o l'�l� Eo
�! Issued by
Permit Fee: Paid
INSPECTION: Check Number:
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
INSPECTOR (Sig)