HomeMy WebLinkAboutDrain Layers Permit 227 Quarry Brook Dri TOWN OF SOUTH WINDSOR
DEPARTMENT OF POLLUTION CONTROL
B/P No.:
South Windsor, Connecticut
List.No.: _
DRAIN LAYER'S PERMIT NO 1661
94&=,A 1 '7 19 �Q
Pursuant to written applicatior, permission is hereby granted to the Licensed D a Layer named herein to-perform
the work indicated below at G y l the
side, between
at premises w d by
whose address is
and to Lay House Drain, Repair House Drain, Lay-Main, Other
for v � occupancy or use,
with Q Family Units, with acres.
Type of Sewage to be c ected under this permit:
SANITARY SEWAGE ( ), INDUSTRIAL WASTES .( ), OR )
Connection will be made with ( ��
Permit to be issued to
the holder of Drain Layer's License No. Permit will expire on i9
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
Sig
ne
Connection Charge Paid 79
Licensed rain Layer
- Issued by
'tax Collector
Permit Fee:. Paid $ _ �t_0 0
INSPECTION: Check Number:Z�
INITIAL 7 l e,, (Sig)
FINAL (Sig)
APPROVED (Date)
(Sig)
INSPECTOR