HomeMy WebLinkAboutDrain Layers Permit 148 Maskel Road TOWN OF SOUTH WINDSOR
DEPARTMENT OF POLLUTION CONTROL
South Windsor, Connecticut B/P No.:
List No.:
DRAIN LAYER'S PERMIT NO 1810
liyk,s `� � 19 7 9
Pursuant to written applicatior, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at 7 b �4 1G�� O Cc C on the
side, between
at premises owned
by td bn-4- �n Oan2t�
whose a::::;Mouse
and to 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 (. ` DUSTRIAL WASTES ( ), OR ( )
Connection will be made with
Permit to be issued toPf' y��C -
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
u 5
Signed
Connectio Charge Paid VDU-D 0 Licensed Drain Layer
C� �SU S
Issued by
Tax Collector
Permit Fee: Paid $ 00
INSPECTION: Check Number:
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
(Sig)
INSPECTOR
PIPPIN MEP-M SERVICE ADM MOMa 0�E
P. 0. Box 53 N 2 1113
BROAD BROOK, CT 06016
623-2313 623-4242 DATE OF ORDER
CUSTOMER'S ORDER NO. PHONE MECHANIC HELPER STARTING DATE
BILL TO
ORDER TAKEN BY
ADDRESS - jjj
/ DAY WORK
clry i CONTRACT
EXTRA
JOB NAME AND LOCATION
JOB PHONE
DESCRIPTION OF WORK:
Td t�icdcr��
y ,
+C
'
�rH�
TOTAL MATERIALS
-•: - TOTAL LABOR
Rik TAX
WORK ORDERED BY -
TOTALAMOUNT $
No one home Total am nt due Total billing to
Signature for ab ork:or be mailed after
1 hereby acknowledge the satisfactory completid Completion
of the above described work. - _of Work