HomeMy WebLinkAboutDrain Layers Permit 256 Quarry Brook Dri TOWN OF SOUTH W1 N DSOR
DEPARTMENT OF POLLUTION CONTROL
South Windsor, Connecticut B/P No.:
List.No.: 7
DRAIN LAYER',S PERMIT NO 1834
-- 0[Z?- -, 19
Pursuant to written applicatior, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at 2ZZ on the
side, between
at ppremises 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 too be co cted under this permit:
SANITARY SEWAGE ( ��` INDUSTRIAL WASTES ( ), OR ( )
Connection will be made with r®. �C-1
Permit to be issued to
the holder of Drain Layer's License No. .2047./; Permit will expire on l9
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
�f aD l7� I/ Signed
C ion Charge Paid YC 00 Licensed EWin Layer
�r�ec�aaa�a
Issued by
Tax Collector a 017 q /�U U
Permit Fee: Paid $
INSPECTION: Ch ck N r:
INITIAL (Sig)
FINAL (Sig)
APPROVED (Date)
(Sig)
INSPECTOR