HomeMy WebLinkAboutDrain Layers Permit 46 Pierce Road TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL B/P No.:
South Windsor, Connecticut
List.No.: _
DRAIN LAYER' S PERMIT O 3472
19 T
Pursuant to written appli atiorr,-Rermiss on is he by granted to the Licensed Drain Layer named herein to perform
the work indicated below at l9 �� /dJ0 on the
side, betwe n
at premises owned by
Y
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 ( ), INDUSTRIAL WASTES .( ), OR ( )
i 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 `
a
r
_ Signed
Connection C aid jj� �� �� Licensed Drain Layer
Issued by
Tag Collector
Permit Fee: Paid $
INSPECTION: Check Number: 7
Ili IITTIAL -- - - - --Sig) - - -- ---- --
FINAL (Sig)
APPROVED (Date)
(Sig)
INSPECTOR