HomeMy WebLinkAboutDrain Layers Permit 158 Quarry Brook Dri TOWN OF SOUTH WINDSOR
DEPARTMENT OF POLLUTION CONTROL
_
South Windsor, Connecticut B/P No.:
List No.:
DRAIN LAYER ' S PERMIT NO 1543
Pursuant to written applicatior, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at C41a z9 y 4X yV %VE .4 o f /C; on the
side, between
at premises owned by ZA L,4 CiA
whose address is
and to _ Lay House Drain, Repair House Drain, Lay Main Other
for X C 11�/D G/V 1 /1/— occupancy or use,
with i5 Family Units, with acres.
Type of Sewage to be connected under this permit:
SANITARY SEWAGE (j(), INDUSTRIAL WASTES ( ), OR ( )
Connection will be made with (� )0VC-
Permit to be issued to T,1 C.-V Ai 1r' Crl
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 9( 'L-
Connection Charge Paid r'Z `T Licensed Drain Layer
Issued by o Z,
Tax Collector -�S=z
Permit Fee: Paid $
INSPECTION: Check Number: 1 r
INITIAL (Sig)
FINAL (Sig)
APPROVED J/ �� (Date)
(Sig)
YNt ECTOR
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