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HomeMy WebLinkAboutDrain Layers Permit 214 Quarry Brook Dri i vwm yr wu i m WINU50K DEPARTMENT OF POLLUTION CONTROL B/P No.: South Windsor, Connecticut List.No.: DRAIN LAYER'S PERMIT NO 1577 19 Pursuant to written applicatior, permission is hereby granted to the Licensed Drain Layer named herein to perform the ork indicated below at Z ' 1 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 ( ), INDUSTRIAL WASTES .( ), OR ( ) Connection will be made with Permit to be issued to the holder of Drain Layer's License No. —2®4!;' Permit will expire on_ zey r3 ! 19_J� 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 &g� Connection Charge PaidOA Z 1171 Licensed drain Kayer t 3©rj Issued by Tax Collector Permit Fee:. Paid $ INSPECTION: Check Number: f�� INITIAL (Sig) FINAL (Sig) APPROVED_ (Date) �.�.� IN SPECTOR (Sig) 9,4 Q _aao QUA � �0 1 a i