HomeMy WebLinkAboutDrain Layers Permit 246 Quarry Brook Dri TOWN OF SOUTH WINDSOR
DEPARTMENT OF POLLUTION CONTROL
South Windsor, Connecticut B/P No.:
List No.: -!tea
DRAIN LAYER'S PERMIT NO 1576
, 19
Pursuant to written application, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at O 2. on the
side, between
IrIV
at premises owned by
whose addres S
and to Lay House Drain, Repair House Drain, Lay Main, Other
for /)eaz�� 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 �l
Permit to be issued to
the holder of Drain Layer's License No.- .c("Jfo„ V 7 Permit will expire on 192
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 ,Z 1917 License&Draia/Layer
- 1-3 oS Issued by
Tax Collector SAD
Permit Fee: Paid $
INSPECTION: Check Number: AP"I Z
INITIAL (Sig)
FINAL (Sig)
APPROVED Z (Date)
(Sig)
INSPECTOR
EASTERN SEWER PIPE CORP.
3320 BERLIN TURNPIKE*NEWINGTON,CONN.06111 PHONE(203)666-5634
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