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HomeMy WebLinkAboutDrain Layers Permit 90 Brookfield Street (2) T T T . ; a OWN" OF SOUTH WI N DSOR DEPARTMENT OF POLLUTION CONTROL B/P No.: South Windsor, Connecticut List No.: _�r DRAIN LAYER'S PERMIT NO 2274 Pursuant to written applicatior, permission is hereby granted to the Licensed Drain Layer named herein to perform the work indicated below at U/ JOB on the side, between at premises owned bye �U 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 ( j, 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 � / p U� Signed Connection Charge Paid Licensed Drain Layer Issued by Tax Collector Permit Fee:. Paid $ INSPECTION: Check Number: INITIAL (Sig) FINAL (Sig) APPROVED (Date) (Sig) INSPECTOR THE JACK FARRELLY COMPANY AIR TESTS _ � L PROJECT: �RaoK}" -� CONTRACTOR:. £ 5L-ATF� TESTED BY- j 'm C( t t LG RI�, CONTRACT NO. INSPECTOR: DATE: Z I LOCATION STARTING TEST PRESSURE TEST PASSED TIME IN LBS/SQ.IN . TIME REMARKS Start Stop Drop In Min. Z W. o 4 .0 Cre i i r e�