HomeMy WebLinkAboutDrain Layers Permit 272 Pierce Road TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL B/P No.:
South Windsor, Connecticut /�
List.No.: _
DRAIN LAYER'S PERMIT NO igls
// , 197 �
Pursuant to written applicatior, permissiV
s hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at 7 2- t e r iyt on the
side, betwe n
at premises owned by Q,V1 t '
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 ( )
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 CONDITION
Signed
Connect Charge Paid -ley`- Licensed Drain Layer
�/ 7f Issued by
Tax Collector
4t4l Permit Fee:. Paid $ �S
INSPECTION: Check Number: Z1, 2
INITIAL (Sig)
FINAL 1P (Sig)
APPROVED (Date)
(Sig)
INSPECTOR
r
r
1 .
7-1
m
'I
NOTES SOUTH WINDSOR POLLUTION CONTROL
LOCATION A Z
OWNER
TYPE OF WORK jLa
DATE PERMIT PIPE G '�
INST R
INSPECTOR v If 1AW46CA&WN BYAOr,��2�