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HomeMy WebLinkAboutDrain Layers Permit 186 Quarry Brook Dri (2) TOWN OF SOUTH WI N DSOR DEPARTMENT OF POLLUTION CONTROL B/P No.: Li South Windsor, Connecticut a /� st.No.: _ DRAIN LAYER'S PERMIT NO 1563 Pursuant to written applicatior, permission is hereby granted to the Licensed Drain Layer named herein to perform r the work indicated below at ®� ✓eti[it.c� .cr 9 on the side, between at premises owned by L C � whose address is r 1 and to 'k Lay House Drain, Repair House Drain, Lay Main, Other , for ;ZeS/97IP—N T//a A— occupancy or use, with O *amily Units, with acres. Type of Sewage to be connected under this permit: SANITARY SEWAGE (X), INDUSTRIAL WASTES ( ), OR ( ) r� Connection will be made with Permit to be issued to the holder of Drain Layer's License No./.?-0,0f—/z ermit 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 Signed Connection Charge Paid 1 12110 Licen!iOR'Draid Layer Issued by Tax Collector Permit Fee: Paid $ INSPECTION: Check Number: Z©�� INITIAL (Sig) FINAL (Sig) APPROVED ® (Date) (Sig) INSPECTOR N 3c,Z 4, M � V� NOTES SOUTH WINDSOR POLLUTION CONTROL LOCATION LY OWNER G o, TYPE OF WORK DATE - _ 74 PERMIT PIPE G INSTALLER INSPECTOR WN BY EASTERN SEWER PIPE CORP. 3326 BERLIN TURNPIKE.NEWINGTON,CONN.06111 PHONE(203)666-5634 i I h 'A. J j/ j; i � a