HomeMy WebLinkAboutDrain Layers Permit 179 Quarry Brook Dri TOWN OF SOUTH WINDSOR
DEPARTMENT OF POLLUTION CONTROL B/P No.:
South Windsor, Connecticut
List No.:
DRAIN LAYER'S PERMIT NO 1579
19
Pursuant to written applicatior, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at 20j, Z on the
side, between
at premises ow ed by--
t �
whose address is
and to L 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:_,�/`,� �t�
SANITARY SEWAGE (v), INDUSTRIAL WASTES ( ), OR ( )
Connection will be made with /i7
Permit to be issued to
the holder of Drain Layer's License No. 0,0 917 Permit will expire on /® —p/ 199.
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 Z 74 LicensffDraVLayer '
Issued by
Tax tollector
Permit Fee:. Paid $Owm
INSPECTION: Check Number: =
INITIAL (Sig)
FINAL (Sig)
APPROVED ¢ Ap— 72 (Date)
Z &a,e,4�1 (Sig)
INSPECTOR
4-
Qs :2 N r�►
i� N
V
450T
LA �
v-
�"
NOTES SOUTH WINDSOR POLLUTION CONTROL
LOCATION 2 O 4/,4 I
OWNER Co
TYPE OF WORK S'e.UA-
DATE _ ' PERMIT PIPE
INSTALLER dl
INSPECTOR WN BY
EASTERN SEWER PIPE CORP.
3320 BERLIN TURNPIKE a NEWINGTON,CONN.06111 PHONE(203)666-5634
L9
I �
�t
)
((f
r
i'
'S�