HomeMy WebLinkAboutDrain Layers Permit 204 Quarry Brook Dri �.� H11rN"DORS'�'OFSOUTOW
DEPARTMENT OF POLLUTION CONTROL B/P No.:
South Windsor, Connecticut
List No.:
DRAIN LAYER'S PERMIT NO 1651
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Pursuant to written applicatior, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at Zr 2 Z 3 Z O K a� �- i �r o o/C Gi on the
side, between
at premises owned by
whose address is
and to 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:
SANITARY SEWAGE ( j, INDUSTRIAL WA TES .(
Connection will be made with AILa
Permit to be issued to
the holder of Drain Laye s Li a No. Permit will expire on 19
The undersigned Drain L er h by agrees all the terms and conditions set forth on the permit and the reverse side
thereof. Appli nt has re\*ved wn Pe t No. and/or C H D Permit No.
for street eacav 'on.
SPECIAL C I
Signed
Connection Charge Paid — g '77 Licensed Drain Layer
o Issued by
Tag Collector
Permit Nee: Paid $
INSPECTION: Check Number: _/
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
(Sig)
INSPECTOR