HomeMy WebLinkAboutDrain Layers Permit 266 Quarry Brook Dri TOWN OF SOUTH WINDSOR
DEPARTMENT OF POLLUTION CONTROL
South Windsor, Connecticut B/P No.:
List No.:
DRAIN LAYER'S PERMIT NO 1609
Pursuant to written appli or, permission is hereby granted to the Licensed Drain Layer named herein to perform
the work indicated below at 7� Z 2 Efe ,, s ,® on the
side, between
at premises o ned by ,
whose address is J I '
and to —JeL"'Lay House Drain, Repair House Drain, Lay-Main, Other
for
occupancy or use,
with Odle Family Units, with acres.
Type of Sewage to be connected under this permit: _
SANITARY SEWAGE INDUSTRIAL WASTES ( ), OR ( )
Connection will be made with f� �� �h'�C_
Permit to.be issued to
the holder of Drain Layer's License No.. �6, � Permit will expire on -0/ 19
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) c�• ,f.' � � �
Signed Y
Connection Charge Paid q p 0 Licens rain ayer
4--- 1 G 9 Issued by
Tax Collector
Permit Fee:. Paid $ JS_r® t7
INSPECTION: Check Number:
INITIAL (Sig)
FINAL (Sig)
APPROVED L 2 S' z (Date)
(Sig)
INSPECTOR
i
CpSTERN`;SEWER PIPE CORP.
3330 BERLIN TURNPIKE*NEWINGTOIV;CONN.p6117
PHONE(203)666-5634
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