HomeMy WebLinkAboutDrain Layers Permit 56 Quarry Brook Driv r TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL B/P No.:
South Windsor, Connecticut
List No.: _
DRAIN LAYER'S PERMIT Np 1410
.r! /3 , 19
Pursuant to written applicatior, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at IO t/l�rl �Q@� 1�G�, IOT �I on the
side, between
at premises owned �je-2ywST Co .
whose address is 44.
and to _ Lay House Drain, Repair House Drain, Lay Main, Other
for '/QLtS/',�E 'Tl f'}� occupancy or use,
with !// Family Units, with acres.
Type of Sewage to be connected under this permit:
SANITARY SEWAGE (Y,), INDUSTRIAL WASTES .( ), OR ( )
Connection will be made with f a JP V G
Permit to be issued to. OL,G�$�'L L.
the holder of Drain Layer's License No. z49-1 `�y Permit will expire on 19
The undersigned Drain Layer hereby agrees to all the terms and conditions set forth on the permit and t e reverse side
thereof. Applicant has received Town Permit No. and/or C H D Permit No.
for street excavation.
SPECIAL CONDITIONS
�/ Signed
Connection Charge Paid--Jo 7 L en ed Drain y
Issued by
Tax Collector
Permit Fee:. Paid $
INSPECTION: Check Number: 1`7
INITIAL (Sig)
FINAL (Sig)
APPROVED ��' i` (Date)
" r '� (Sig)
I0 P OR
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NOTES SOUTH WINDSOR POLLUTION CONTROL
LOCATION
OWNER
TYPE OF WORK
DATE PERMIT PIPE
INSTALLER
INSPECTOR DRAWN BY ='
JULIA i?ACK.AVSKI JOi-� iVS N.
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I hereby certify that this map is substatt•4
tially correct
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ACHE"ISACH REALTY
0 1 C0N1 PAN IES
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E P L O T P L A (\1
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QUARRY BROOK DRIVIE
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