HomeMy WebLinkAboutdrain layer permit 720 Sullivan Avenue TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL B/P No.:
South Windsor, Connecticut -3�6 7
List No.:
DRAIN LAYER'S PERMIT NO 2187
Pursuant to written applicatios, permission is)hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at /nao Su l l l✓Gt � /q-/r on the
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.
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
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Connection Charge Paid -�0 Licensed Drain Layer
Issued by
Tax Collector
Permit Fee:. Paid $ !S
INSPECTION: Check Number: sdQ 2
INITIAL (Sig) Ciro�Sri1i°uJS�%
FINAL (Sig)
APPROVED (Date)
(Sig)
INSPECTOR
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