HomeMy WebLinkAboutdrain layer permit 0000 Sullivan Avenue (5) TOWN OF SOUTH WINDSOR
DEPARTMENT OF POLLUTION CONTROL
South Windsor, Connecticut B/P No.:
List No.: _
DRAIN LAYER'S PERMIT 1Tp 2700
19
Pursuant to written appli5Atior, permission is hereby gran fed to the Licensed D din Layer named herein to perform
the work indicated below at i i.1 z t Q �/I ; �T p m
side, between on the
at premises owned
whose address is
and to Lay House Drain, Repair House Drain,
Lay Main,
for Other
with occupancy or use,
Family Units, with
Type of Sewage to be connected under this permit: acres.
SANITARY SEWAGE ( ), INDUSTRIAL WASTES ( ) OR
Connection will be made with ( )
Permit to be issued to
the holder of Drain Layer's License No. 01 C) Permit w�}
expe on
The undersigned Drain Layer hereby agrees to all the terms and conditions s tlfor hmon he permit and the reverse side
thereof. Applicant has received Town Permit No.
Ifor street excavation. and/or C H D Permit No.
ISPECIAL CONDITIONS
_ v
Connection Charge Paid Signed
nse Drain ay
Tax Collector Issued by
Permit Fee: Paid aid $ __—
INSPECTION: Check Number: /6J 0—6
-INITIAL
� (Sig)
FINAL
' (Sig)
APPROVED
;I
(Date)
� I
INSPECTOR (Sig)
,I