HomeMy WebLinkAboutDrain Layers Permit 20 Quarry Brook Driv TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL
B/P No.:
South Windsor, Connecticut IBIS
List No.: _ d
DRAIN LAYER'S PERMIT NO 1241
�D. Q , g , 19
Pursuant to written appli tior, permission is here ranted to the Lice sed Drain La r named herein to perform
the work if d�i ated ow at / �':� �d on the
yu side between A at premises 0GI
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 rASTES . R
y
Connection will be made with
Permit to be issued to
the holder of Drain Layer's License No. — 20 2 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
p
Signed L-1-IfL6�le-,, 1 �//6
Connection Charge Paid Jj` 7 Licensed Drain Layer
Q�f Issued by
Tax Collector J�
Permit Fee: Paid $ _!^`�?'
INSPECTION: Check Number: z 1 4-
INITIAL (Sig)
FINAL (Sig)
APPROVED /� �° (Date)
(Sig)
INSPECTOR i`
-11
26
5"67
I�
NOTES SOUTH WINDSOR POLLUTION CONTROL
LOCATION o - r7ke �O
OWNER Ololn
TYPE OF WORK n&At
DATE - - RM T > PIPE
INSTALLER
INSPECTOR DRAWN BY C
liar
__.
`�
i
ct� -
N
n
�i
IS
NOTESSOUTH WINDSOR POLLUTION CONTROL
LOCATIO z o u ,ee•
OWNER
TYPE OF WO
DATE 7- 1- 74, PERMIT --- PIPE
INSTALLER
INSPECTOR DRAWN BY