HomeMy WebLinkAboutDrain Layers Permit 139 Quarry Brook Dri TOWN OF SOUTH WINDSOR
DEPARTMENT OF POLLUTION CONTROL.
South Windsor, Connecticut B/P No.:
List.No.: '` �
DRAIN LAYER'S PERMIT
957
�e t"b�tbi► ' 19
Pursuant to written applicatior, permission is hereby granted to the Licensed Drain Layer named herein to"perform
the work indicated below at �A
i� on the
side,,between
at premises owned
whose address is
and to _X_Lay House Drain, Repair House Drain,
for _ Lay Main, Other -
occupancy or use,
with Family Units, with
acres.
Type of Sewage to be connected under this permit:
SANITARY SEWAGE (,X), INDUSTRIAL WASTES .( ), OR
Connection will be made with
------------
Permit to be issued to
the holder of Drain Layer's License No. j
expire on
The undersigned Drain Layer hereby agrees to al the terms and cond'tions set Permit lforth on the permit the reverse s9 0
thereof. Applicant has received Town Permit No. and/or C H D Permit No.
for street egcav` tion.
--- - -- --SPECIA_ CONDITIONS
Connection Charge Paid
Signed Otr'
Licensed;Dra' yet
Tag Collector Issued by
Permit Fee: Paid $ 9 •
INSPECTION: Check Number:
INITIAL (Sig)
FINAL tmI14 Q /say ..
(Sig)
APPROVED i 4 L 67-o " t�9 (Date)
(Sig)
INSPECTOR
i474(a /sire
'41-45ro�o
� 6
Cam' �