HomeMy WebLinkAbout1976-6-2 - 150 Felt Road - Septic ApplicationTOWN OF SOUTH WINDSOR
DEPARTMENT OF POLLUTION CONTROL
South Windsor, Connecticut
DRAIN LAYER'S PERMIT
B/P No..
List No.: S c c p 3 y
N° 1100
, 19
Pursuant to written applicatior, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at , _ _ on the
side, between_ 4.
at premises owned by
whose address is
and to Lay House Drain, Repair House Drain, Lay Main, Other
for
with Family Units, with
Type of Sewage to be connected under this permit:
SANITARY SEWAGE ( ), INDUSTRIAL WASTES ( ), OR ( )
Connection will be made with
occupancy or use,
acres.
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
Connection Charge Paid
Tax Collector
Signed
Issued by
INSPECTION:
Licensed Drain Layer
Permit Fee: Paid $
Check Number:
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
(Sig)
INSPECTOR
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