HomeMy WebLinkAboutDrain Layers Permit 178 Quarry Brook Dri TOWN OF SOUTH WI N DSOR
DEPARTMENT OF POLLUTION CONTROL
B/P No.:
South Windsor, Connecticut
List.No.:
DRAIN LAYER'S PERMIT NO 1575
jj� -2 - 197 2
Pursuant to written applicatior, permission is hereby granted to the Licensed Drain Layer named herein to perform
the wo indicated below at on the
side, between
at premises owned by
whose address 's_�
and to ! Lay House Drain, Repair House Drain, Lay Main, Other
for occupancy or use,
with in4-2 Family Units, with acres.
Type of Sewage to be connected under this permit:
SANITARY SEWAGE ( ', NDUSTRIAL WAASTES ( ), (OR ( )
Connection will be made with
Permit to be issued to
the holder of Drain Layer's License No. .20,o 9;9/7' Permit will expire on /pep/ 192g.
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
Connection Charge Paid L 7 Licensed in L er or 10
fq Issued by
Tax Collector 00
Permit Fee: Paid $
INSPECTION: Check Number: 1P
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
INSPECTOR (Sig)
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NOTES SOUTH WINDSOR POLLUTION CONTROL
E GTE LOCATION 2--o zzQ v a
OWNER c c o ,
TYPE OF WORK ry• e
DATE - 6- 4 PERMIT /-57A PIPE
INSTALLER G
/��°' INSPECTOR DRAWN BY
EASTERN SEWER PIPE- CORP.
3320 BERLIN TURNPIKE a NEWINGTON,CONN.06111 PHONE(203)666-5634
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