HomeMy WebLinkAboutDrain Layers Permit 80 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 _ 1822
42kL ' 19 _
Pursuant to written applicatior, permission is hereby granted to the LicensedDrain Layer named herein to perform
the work indicated below at O !� (� r C Y ` on the
side, between
at premises owned by G— YS S. r4 b w j.,
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 Ct r_ G Gck L C I. S
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 1. �.�✓�C�
Connection Charge Paid 6b Licensed Drain Layer
Issued by 6
Tax CollectorCIO
S'Permit Fee:. Paid $ 16--//
INSPECTION: Check Number:
INITIAL (Sig)
FINAL (Sig)
7
APPROVED — / (Date)
(Sig)
INSPECTOR
1
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NOTES SOUTH WINDSOR POLLUTION CONTROL
LOCATION
OWNER °
TYPE OF WORK
DATE 17 24PERMIT PIPE
INSTALLER
INSPECTOR ` DRAWN BY