HomeMy WebLinkAboutDrain Layers Permit Building 1, Bissell TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL
B/P No.:
South Windsor, Connecticut
List No.: _
DRAIN LAYER'S PERMIT N? 3053
00
Pursuant to written applica/tior, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at - 13 5 s 10 f Cc rK e✓! -s -4
on the
side, between
at premises!owned by f��`�l��� �o1Y1 /y/ V 5c
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
Signed
Connection Cha ge Paid Licensed Drain Layer
ax Collector Issued by /
Permit lee: Paid $
INSPECTION: Check Number:
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
INSPECTOR (Sig)