HomeMy WebLinkAboutdrain layer permit 1540 Sullivan Avenue TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL Bhp No.:
South Windsor, Connecticut
List No.:
DRAIN LAYER'S PERMIT NO 2713
�O2 , 19SF
Pursuant to written application, permi sion is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at l7 V / /y`- on the
side, between
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. lj
SPECJAL CONDITIONS
Signed
Connection rge Paid Licensed Drain Layer
t
Issued by .
Tax Collector
Permit Fee:. Paid $ �—
INSPECTION: Check Number: CJ
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
(Sig)
INSPECTOR
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