HomeMy WebLinkAboutDrain Layers Permit 227 Quarry Brook Dri (2) TOWN OF SOUTH WINDSOR
DEPARTMENT OF POLLUTION CONTROL
South Windsor, Connecticut B/P No.:
List.No.: Z—
DRAIN LAYER'S PERMIT - -
N° 16'75
Pursuant to written applicatior, permission is hereby granted to the Licensed Drain Layer named herein to"perform
the work indicated below at —7tt o� Q�a r ry D ' ,
on the
side, between
at premises owned by
whose address is -2-0 ? Jv
and to Lay House Drain, Repair House Drain, La Mi
Yan, 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. Permit will expire on 1
The undersigned Drain Layer hereby agrees to all the terms and conditions set forth on the permit an the reverse side
thereof. Applicant has received Town Permit No. :for street excavation. and/or C H D Permit No
SPECIAL CONDITIONS
r� ���-L Asa
Connection Charge Paid ��Cy, Signed -Licensed Dr'
yeraw-layer
/ 373
Tax Collector Issued by ^L
Permit ee: Paid $
INSPECTION: Check Number: _g '
INITIAL (Sig)
FINAL
(Sig)
APPROVED_ /I ?"? - (Date)
INSPECTOR (Sig)
NOTES SOUTH WINDSOR POLLUTION CONTROL
LOCATION
OWNER /-/4� o�S
TYPE OF WORK
DATE 7,Iz-791 PERMIT PIPE vc,
INSTALLERG
INSPECTOR DRAWN BY