HomeMy WebLinkAboutDrain Layers Permit 142 Brook Street TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL
B/P No.:
South Windsor, Connecticut
y'Z List.No.:
DRAIN LAYER'S PERMIT NO 1169
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19 Der 19 76
Pursuant to written applicatior, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at 142 Brook Street on the
�i SST' side, between
at premises owned by Gerald DPrey
whose address is same
and to XX Lay House Drain, Repair House Drain, Lay Main, Other
for Residential occupancy or use,
with One Family Units, with acres.
Type of Sewage to be connected under this permit:
SANITARY SEWAGE (XXC INDUSTRIAL WASTES ( ), OR ( )
Connection will be made with Sixx inch Plastic Pipe V
Permit to be issued to Vito Covenskv
the holder of Drain Layer's License No. Permit will expire on 19 Dec ber 19 ne
The undersigned Drain Layer hereby agrees to all the terms and conditions set forth on the permit and the reverse si3e
thereof. Applicant has received Town Permit No. and/or C H D Permit No.
for street excavation.
SPECIAL CONDITIONS
Signed
Connection Charge Paid Licensed Drain ayer
1047 Issued by M. Timot riend
Tax Collector
Permit Fee:. Paid $
INSPECTION: Check Number:
INITIAL (Sig)
FINAL (Sig)
APPROVED ! Date)
(Sig)
S ECTOR