HomeMy WebLinkAboutdrain layer permit 938 Sullivan Avenue (2) TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL
South Windsor, Connecticut
DRAIN LAYER' S PERMIT A 132
' 1 9— -
Pursuant to written application, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at _WW on the
side, between
at premises owned b .► AL
whose address isWNW
and to _Lay House Drain, Repair House Drain, Lay Main, Other
for occupancy or use,
with am Family Units, with acres.
Type of Sewage to be connected under this permit:
SANI A Y 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
Connection Charge Paim 60" Licensed Drain Layer
'� (Sig) Issued by
Tax Collector
Permit Fee: Paid $.�
INSPECTION:
INITIAL g (Sig)
FINAL (Sig)
APPROVED s 19M (Date)
".�� ! (Sig)
INSPE OR